Anthem Blue Cross Blue Shield of California policies, page 2

Search Anthem Blue Cross Blue Shield of California's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

576 public policies Substrate tracks for Anthem Blue Cross Blue Shield of California, by title.

Anthem Blue Cross Blue Shield of California policies
PolicyDetailsCodesSource
California Facility and Professional Provider ManualEffective Nov 1, 2020 · Commercial, Medicaid · CA54Original policy ↗
California Facility and Professional Provider ManualEffective Aug 1, 2023 · Commercial, Medicaid · CA55Original policy ↗
California Facility and Professional Provider ManualEffective Aug 1, 2022 · Commercial, Medicaid · CA55Original policy ↗
California Facility and Professional Provider ManualCABC-CM-PM-066114-24 · Effective Jan 1, 2025 · Commercial, Medicaid · CA47Original policy ↗
California PPO Prior Authorization ListCommercial · CA3,545Original policy ↗
Cellular Therapy Products for Allogeneic Stem Cell TransplantationMED.00147 · Commercial2Original policy ↗
CG-ADMIN-01 Clinical Utilization Management (UM) Guideline for Pre-Payment Review Medical Necessity Determinations When No Other Clinical UM Guideline ExistsCG-ADMIN-01 · Commercial62Original policy ↗
CG-ANC-03 AcupunctureCG-ANC-03 · Commercial4Original policy ↗
CG-ANC-04 Ambulance Services: Air and WaterCG-ANC-04 · Commercial8Original policy ↗
CG-ANC-05 Ambulance Services: Ground; EmergentCG-ANC-05 · Commercial11Original policy ↗
CG-ANC-06 Ambulance Services: Ground; Non-EmergentCG-ANC-06 · Commercial8Original policy ↗
CG-ANC-07 Inpatient Interfacility TransfersCG-ANC-07 · Commercial—Original policy ↗
CG-ANC-08 Mobile Device-Based Health Management ApplicationsCG-ANC-08 · Commercial—Original policy ↗
CG-BEH-14 Intensive In-home Behavioral Health ServicesCG-BEH-14 · Commercial7Original policy ↗
CG-BEH-15 Activity Therapy for Autism Spectrum Disorders and Rett SyndromeCG-BEH-15 · Commercial1Original policy ↗
CG-DME-03 Neuromuscular Stimulation in the Treatment of Muscle AtrophyCG-DME-03 · Commercial3Original policy ↗
CG-DME-04 Transcutaneous Electrical Nerve StimulationCG-DME-04 · Commercial5Original policy ↗
CG-DME-05 Cervical Traction Devices for Home UseCG-DME-05 · Commercial6Original policy ↗
CG-DME-06 Compression Devices for LymphedemaCG-DME-06 · Commercial26Original policy ↗
CG-DME-07 Augmentative and Alternative Communication Devices with Digitized or Synthesized Speech OutputCG-DME-07 · Commercial10Original policy ↗
CG-DME-08 Infant Home Apnea MonitorsCG-DME-08 · Commercial6Original policy ↗
CG-DME-10 Durable Medical EquipmentCG-DME-10 · Commercial1Original policy ↗
CG-DME-12 Home Phototherapy Devices for Neonatal HyperbilirubinemiaCG-DME-12 · Commercial2Original policy ↗
CG-DME-15 Hospital Beds and AccessoriesCG-DME-15 · Commercial34Original policy ↗
CG-DME-16 Pressure-Reducing Support SurfacesCG-DME-16 · Commercial22Original policy ↗
CG-DME-18 Home Oxygen TherapyCG-DME-18 · Commercial36Original policy ↗
CG-DME-19 Therapeutic Shoes, Inserts, or Modifications for Individuals with DiabetesCG-DME-19 · Commercial12Original policy ↗
CG-DME-20 Orthopedic FootwearCG-DME-20 · Commercial66Original policy ↗
CG-DME-21 External Infusion Pumps for the Administration of Drugs in the Home or Residential Care SettingsCG-DME-21 · Commercial8Original policy ↗
CG-DME-23 Lifting Devices for Use in the HomeCG-DME-23 · Commercial10Original policy ↗
CG-DME-24 Wheeled Mobility Devices: Manual Wheelchairs - Standard, Heavy Duty and LightweightCG-DME-24 · Commercial57Original policy ↗
CG-DME-26 Back-Up Ventilators in the Home SettingCG-DME-26 · Commercial4Original policy ↗
CG-DME-30 Prothrombin Time Self-Monitoring DevicesCG-DME-30 · Commercial5Original policy ↗
CG-DME-31 Powered Wheeled Mobility DevicesCG-DME-31 · Commercial84Original policy ↗
CG-DME-33 Wheeled Mobility Devices: Manual Wheelchairs-Ultra-LightweightCG-DME-33 · Commercial1Original policy ↗
CG-DME-34 Wheeled Mobility Devices: Wheelchair AccessoriesCG-DME-34 · Commercial213Original policy ↗
CG-DME-35 Electric Breast PumpsCG-DME-35 · Commercial3Original policy ↗
CG-DME-36 Pediatric Gait TrainersCG-DME-36 · Commercial3Original policy ↗
CG-DME-37 Air Conduction Hearing AidsCG-DME-37 · Commercial31Original policy ↗
CG-DME-39 Dynamic Low-Load Prolonged-Duration Stretch DevicesCG-DME-39 · Commercial23Original policy ↗
CG-DME-40 Noninvasive Electrical Bone Growth Stimulation of the Appendicular SkeletonCG-DME-40 · Commercial2Original policy ↗
CG-DME-41 Ultraviolet Light Therapy Delivery Devices for Home UseCG-DME-41 · Commercial4Original policy ↗
CG-DME-42 Continuous Glucose Monitoring DevicesCG-DME-42 · Commercial15Original policy ↗
CG-DME-43 High Frequency Chest Compression Devices for Airway ClearanceCG-DME-43 · Commercial2Original policy ↗
CG-DME-44 Electric Tumor Treatment Field (TTF)CG-DME-44 · Commercial4Original policy ↗
CG-DME-45 Ultrasound Bone Growth StimulationCG-DME-45 · Commercial2Original policy ↗
CG-DME-46 Pneumatic Compression Devices for Prevention of Deep Vein Thrombosis of the Extremities in the Home SettingCG-DME-46 · Commercial18Original policy ↗
CG-DME-47 Noninvasive Home Ventilator Therapy for Respiratory FailureCG-DME-47 · Commercial3Original policy ↗
CG-DME-48 Vacuum Assisted Wound Therapy in the Outpatient SettingCG-DME-48 · Commercial7Original policy ↗
CG-DME-49 Standing FramesCG-DME-49 · Commercial6Original policy ↗

Back to Anthem Blue Cross Blue Shield of California · Anthem Blue Cross Blue Shield of California prior authorization CPT list

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.