CommercialPrior AuthMedium impact
[Georgia] Prior authorization requirement updates — Carelon Medical Benefits Management
Anthem BCBS·GA · Cardiology, Cardiothoracic Surgery·Provider Bulletin
Effective date
Oct 1, 2026
We identified it
Jun 13, 2026
Summary
Effective October 1, 2026, five cardiovascular procedures including implantable cardioverter-defibrillator systems and substernal electrodes will require prior authorization through Carelon Medical Benefits Management for Georgia commercial plans. This affects cardiac device procedures and pulse generator replacements.
Action Required
Before October 1, 2026: Billing team must update prior authorization requirements for CPT codes 0571T, 0572T, 0573T, 0574T, and 33262 in billing system. Providers performing cardiovascular device procedures must obtain prior auth through Carelon's provider portal at https://providerportal.com or via Availity Essentials. Update encounter forms and EMR to prompt for prior authorization. Claims will be denied without proper authorization.