Prior Authorization Summary/Code List Archive

This page includes the prior authorization summaries and code list documents that were previously posted.

2024 Procedure Code Lists Effective 01/01/2024

2024 Procedure Code Lists Effective 02/01/2024

2024 Procedure Code Lists Effective 03/01/2024

2024 Procedure Code Lists Effective 04/01/2024

2024 Procedure Code Lists Effective 05/01/2024

2024 Procedure Code Lists Effective 06/01/2024

2024 Procedure Code Lists Effective 07/01/2024

Checking eligibility and benefits and/or obtaining prior authorization is not a guarantee of payment of benefits. Payment of benefits is subject to several factors, including, but not limited to, eligibility at the time of service, payment of premiums/contributions, amounts allowable for services, supporting medical documentation, and other terms, conditions, limitations, and exclusions set forth in the member’s policy certificate and/or benefits booklet and or summary plan description. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. If you have any questions, call the number on the member's BCBSNM ID card.