Important changes to Blue Cross and Blue Shield of North Carolina Prior Authorization effective July 1, 2024

Effective July 1, 2024, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will expand the list of codes and services that require prior authorization.

This change covers Commercial plans, including Individual, Fully Insured, Administrative Services Only (ASO) and State Health Plan and Medicare Advantage plans for services performed on or after July 1, 2024. The Federal Employee Program plan is not impacted by this change.

The additional codes to require prior plan approval for Commercial and Medicare Advantage plans beginning July 1 will be listed on the second quarter prior review list by April 10, 2024.

A listing of Blue Cross NC services and CPT codes are available here: Services and CPT codes | Providers | Blue Cross NC.