Effective Date: Oct. 1, 2026

Health Plans Affected: Advantage MD, Employer Health Programs (EHP), Priority Partners, US Family Health Plan (USFHP) 

Type of Change: New Codes and Authorization Requirements Status

Explanation of Change:

Please note the authorization requirements for quarterly new codes listed in the chart below, effective Oct. 1, 2026. 

Oct. 2026 Quarterly New Codes Review

Prior Authorization Process

• Please use our secure online portal, Availity, to submit electronic prior authorization requests. 
  
• For codes subject to prior authorization through EviCore, providers should submit prior authorization requests via the EviCore portal through Availity, the EviCore portal directly, or, if the portal cannot be accessed, by calling EviCore at 866-220-3071.