| 2021 FEP Precertification Requirements | Commercial · GA | — | Original policy ↗ |
| ACP Referral Tracking Guide | Commercial · CT, GA, NH, VA | 4 | Original policy ↗ |
| Activities Schedule (January start) | Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| Activities Schedule (July start) | Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| ADA Claim Form | Commercial, Medicaid · CO, CT, GA, IN, KY, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| ADMIN.00001 Medical Policy Formation | ADMIN.00001 · Commercial | — | Original policy ↗ |
| ADMIN.00002 Preventive Health Guidelines | ADMIN.00002 · Commercial | — | Original policy ↗ |
| ADMIN.00004 Medical Necessity Criteria | ADMIN.00004 · Commercial | — | Original policy ↗ |
| ADMIN.00005 Investigational Criteria | ADMIN.00005 · Commercial | — | Original policy ↗ |
| ADMIN.00007 Immunizations | ADMIN.00007 · Commercial | — | Original policy ↗ |
| Affordable Care Act Compliant Health Plans Quick Reference Guide | Commercial · GA | — | Original policy ↗ |
| After-Hours, Emergency, and Miscellaneous E/M Services – Professional and Facility | C-07001 · Effective Oct 23, 2025 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 6 | Original policy ↗ |
| AIM Specialty Health Solutions | Commercial · CT, GA, NH, VA | — | Original policy ↗ |
| Alcohol Use Assessment Brochure | Commercial · CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| Allowed Virtual Services in Addition to CPT Appendix P | MULTI-BCBS-CM-050974-24 · Effective Feb 17, 2024 · Commercial · CO, CT, GA, IN, KY, MO, NV, OH, WI | 96 | Original policy ↗ |
| Ambulance Transportation - Professional | C-19001 · Effective Jun 1, 2024 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | — | Original policy ↗ |
| Ambulatory Electroencephalography | CG-MED-46 · Commercial | 22 | Original policy ↗ |
| ANC.00006 Biomagnetic Therapy | ANC.00006 · Commercial | 1 | Original policy ↗ |
| ANC.00007 Cosmetic and Reconstructive Services: Skin Related | ANC.00007 · Commercial | 26 | Original policy ↗ |
| ANC.00008 Cosmetic and Reconstructive Services of the Head and Neck | ANC.00008 · Commercial | 61 | Original policy ↗ |
| ANC.00009 Cosmetic and Reconstructive Services of the Trunk, Groin, and Extremities | ANC.00009 · Commercial | 23 | Original policy ↗ |
| Anesthesia Services – Professional | C-09002 · Effective Mar 11, 2026 · Commercial · CO, CT, GA, IN, KY, MO, NH, NV, OH, WI | 33 | Original policy ↗ |
| Annual HEDIS Calendar | Commercial, Medicaid · CA, CO, CT, GA, IN, KY, ME, MO, NH, OH, VA, WI | — | Original policy ↗ |
| ANTHEM BLUE CROSS AND BLUE SHIELD PROVIDER INQUIRY/REFUND/ADJUSTMENT FORM | Commercial · CO, CT, GA, ME, NH, NV, VA | 2 | Original policy ↗ |
| Anthem ePass Quick Start Guide | Commercial · CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, NY, OH, VA, WI | — | Original policy ↗ |
| Antibiotic Resistance | Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| Antidepressant Medication Management | Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| Applied Behavior Analysis (ABA) Provider Resource Guide | MULTI-BCBS-CM-072378-24-CPN72366 · Commercial · CT, GA, IN, KY, ME, MO, NH, OH, VA | 10 | Original policy ↗ |
| Autologous and Allogeneic Pancreatic Islet Cell Transplantation | TRANS.00010 · Commercial | 9 | Original policy ↗ |
| Automated Evacuation of Meibomian Gland | MED.00103 · Commercial | 3 | Original policy ↗ |
| BlueCard Claims Filing | Commercial · GA | — | Original policy ↗ |
| Border County Provider Claims | Commercial · GA | — | Original policy ↗ |
| Brain Computer Interface Rehabilitation Devices | DME.00052 · Commercial | 1 | Original policy ↗ |
| Breast Cancer Screening | Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | — | Original policy ↗ |
| Bundled Services and Supplies - Facility | C-23001 · Effective Jun 1, 2026 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 46 | Original policy ↗ |
| Bundled Services and Supplies - Professional | C-08003 · Effective Jun 24, 2026 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 390 | Original policy ↗ |
| Cellular Therapy Products for Allogeneic Stem Cell Transplantation | MED.00147 · Commercial | 2 | Original policy ↗ |
| CG-ADMIN-01 Clinical Utilization Management (UM) Guideline for Pre-Payment Review Medical Necessity Determinations When No Other Clinical UM Guideline Exists | CG-ADMIN-01 · Commercial | 62 | Original policy ↗ |
| CG-ANC-03 Acupuncture | CG-ANC-03 · Commercial | 4 | Original policy ↗ |
| CG-ANC-04 Ambulance Services: Air and Water | CG-ANC-04 · Commercial | 8 | Original policy ↗ |
| CG-ANC-05 Ambulance Services: Ground; Emergent | CG-ANC-05 · Commercial | 11 | Original policy ↗ |
| CG-ANC-06 Ambulance Services: Ground; Non-Emergent | CG-ANC-06 · Commercial | 8 | Original policy ↗ |
| CG-ANC-07 Inpatient Interfacility Transfers | CG-ANC-07 · Commercial | — | Original policy ↗ |
| CG-ANC-08 Mobile Device-Based Health Management Applications | CG-ANC-08 · Commercial | — | Original policy ↗ |
| CG-BEH-14 Intensive In-home Behavioral Health Services | CG-BEH-14 · Commercial | 7 | Original policy ↗ |
| CG-BEH-15 Activity Therapy for Autism Spectrum Disorders and Rett Syndrome | CG-BEH-15 · Commercial | 1 | Original policy ↗ |
| CG-DME-03 Neuromuscular Stimulation in the Treatment of Muscle Atrophy | CG-DME-03 · Commercial | 3 | Original policy ↗ |
| CG-DME-04 Transcutaneous Electrical Nerve Stimulation | CG-DME-04 · Commercial | 5 | Original policy ↗ |
| CG-DME-05 Cervical Traction Devices for Home Use | CG-DME-05 · Commercial | 6 | Original policy ↗ |
| CG-DME-06 Compression Devices for Lymphedema | CG-DME-06 · Commercial | 26 | Original policy ↗ |
