CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · ENT (Ear, Nose & Throat)·Medical Policy
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross is adding restricted coverage for Balloon Dilation of the Eustachian Tube (BDET) effective January 1, 2026. The procedure will now be covered for adults with chronic obstructive eustachian tube dysfunction when specific clinical criteria are met, including 12+ months of symptoms, failed medical management, and comprehensive diagnostic assessment.
Action Required
Before January 1, 2026: Billing team must establish prior authorization requirements for Balloon Dilation of Eustachian Tube procedures. ENT providers must document all required criteria including 12+ months of symptoms, comprehensive diagnostic assessment results, failed medical management, and rule-out of other conditions. Update encounter forms and EMR templates to capture required documentation elements. Claims without proper documentation will be denied.