Medicare AdvantagePrior AuthHigh impact
Changes to Our Prior Authorization Programs for Medicare Advantage
BCBS Oklahoma·OK·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Effective January 1, 2026, BCBS Oklahoma has transitioned prior authorization management for Medicare Advantage members from EviCore to internal BCBS Oklahoma management for most care categories, reducing prior authorization requirements to fewer than 20% of codes. Proton Beam Therapy Services will continue to be managed by EviCore.
Action Required
Immediately: Billing team must redirect all prior authorization requests for Medicare Advantage members to BCBS Oklahoma instead of EviCore (except Proton Beam Therapy). Update workflow to verify authorization requirements through Availity Essentials or member ID card before submitting requests. Review updated prior authorization code lists on BCBS Oklahoma website to identify which codes still require authorization.