Medicare AdvantagePrior AuthMedium impact
Medical policy updates
Blue Cross Blue Shield of Rhode Island·RI · Cardiology, OB-GYN, Pain Management +3 more·Physician / Facility
Effective date
Feb 1, 2025
We identified it
Jun 19, 2026
Summary
Multiple policy changes affecting hearing evaluations, blood typing, fetal surgery, and prior authorization requirements. Key changes include continued non-coverage of hearing evaluation codes, new prior auth requirements for several procedures, and coverage expansion for fetal surgery.
Action Required
By February 1, 2025: Billing team must update prior authorization requirements for CPT codes 33285 (commercial only), 57288, 64640, 64633, and 64635 (Medicare Advantage and commercial). Update billing system to flag these codes for pre-authorization. Continue to avoid billing CPT 92562, 92572, and 92576 for hearing evaluations as they remain non-covered. Update system to allow billing S2404 for fetal surgery when medical criteria are met.