
Important information during the coronavirus (COVID-19) pandemic
For temporary changes and recommendations for providers, refer to our COVID-19 provider webpage
Find more information for providers:
- Log in to our provider portal (availity.com)*.
- Click Payer Spaces on the Availity menu bar.
- Click the BCBSM and BCN logo.
- Click Secure Provider Resources (Blue Cross and BCN) on the Resources tab.
- Click Coronavirus on the Member Care tab.
This page provides Blue Cross Blue Shield of Michigan's prior authorization requirements, including information that applies to:
For both Blue Cross commercial and Medicare Plus Blue members
- Summary of utilization management programs for Michigan providers (PDF)
- Procedure codes for which providers must request prior authorization (PDF)
- Provider preauthorization and precertification requirements (PDF)
- Holiday closures: How to submit authorization requests for inpatient admissions (PDF)
- Diabetes: For coaching, management, behavioral counseling and supplies (PDF) - Includes information about care management and utilization management programs
- Durable medical equipment and prosthetics and orthotics: For authorization determinations (PDF)
- Inpatient medical admissions
- Submitting acute inpatient authorization requests: Frequently asked questions for providers (PDF)
- Inpatient authorization requests: Tips for using the e-referral system – Blue Cross PPO (PDF)
- Inpatient medical admissions, acute care (hospitals): For authorization determinations (PDF) - Includes information about our utilization management program
- Post-acute care: For skilled nursing, rehabilitation and long-term acute care facilities (PDF) - Includes information about our utilization management programs
- Surgeries: For decision support and authorization determinations (PDF) - Includes information about our care management and utilization management programs
Utilization management criteria – Blue Cross commercial and Medicare Plus Blue
- Effective Aug. 1, 2023, there are no local rules for acute inpatient medical admissions of adults.
- 2022 Blue Cross and BCN Local Rules for acute inpatient medical admissions of adults (PDF) – effective March 1, 2022, through July 31, 2023
- Local Rules for acute inpatient medical admissions of adults: Frequently asked questions (PDF) - effective March 1, 2022, through July 31, 2023
Forms – Blue Cross commercial and Medicare Plus Blue
- Criteria Request Form (for non-behavioral health cases) (PDF)
For Blue Cross commercial members
Information on requesting authorization – Blue Cross commercial
- Post-acute care admissions: Submitting authorization requests (PDF)
- Northwood DME/POS management program:
- Private duty nursing program (PDF)
- Transplants: For authorization determinations (PDF) - Includes information about utilization management programs
Utilization management criteria – Blue Cross commercial
- 2023 Blue Cross and BCN Local Rules for post-acute care (PDF) - for commercial members only, effective Aug. 1, 2023
- 2022 Blue Cross and BCN Local Rules for post-acute care (PDF) - for commercial members only, effective Aug. 1, 2022, through July 31, 2023
Forms – Blue Cross commercial
- Acute inpatient hospital assessment form (PDF) — for commercial members only
- SNF/acute IPR assessment form (PDF) — for commercial members only
- Federal Employee Program® Consent for Case Management (PDF)
- LTACH assessment form (PDF) — for commercial members only
- Peer-to-peer reviews:
Air ambulance authorization requests – Blue Cross commercial
- Non-emergency air ambulance prior authorization program: Overview for MI and non-MI providers (PDF)
- Air ambulance flight information (non-emergency) form (PDF)
- Air ambulance: For non-emergency flights (PDF) - Includes information about the utilization management program
Blue Cross PPO (commercial) Provider Manual
To access the manual, complete these steps:
- Log in to our provider portal (availity.com)*.
- Click Payer Spaces on the Availity menu bar.
- Click the BCBSM and BCN logo.
- Click Provider Manuals on the Resources tab.
- Click Blue Cross commercial.
For Medicare Plus Blue members
Services that require authorization – Medicare Plus Blue
- Services That Require Authorization – Medicare Plus Blue PPO (PDF)
- About Blue Dot changes to the list of Services That Require Authorization (PDF)
- How to request a peer-to-peer review with a Blue Cross or BCN medical director (PDF)
- Cosmetic procedures: For authorization determinations (PDF) - Includes information about our utilization management programs
- Elective procedures and services: For authorization determinations (PDF) - Includes information about our care management and utilization management programs
- Post-acute care services: Frequently asked questions by providers (PDF)
Forms – Medicare Plus Blue
- Medicare Plus Blue Acute Inpatient Fax Assessment Form (PDF)
Authorization criteria and preview questionnaires – Medicare Plus Blue
We use our authorization criteria or our medical policies to make determinations on prior authorization requests for select services. To determine which services have authorization criteria and view authorization criteria and preview questionnaires, see the Authorization criteria and preview questionnaires (PDF).
* Clicking this link means that you're leaving the Blue Cross Blue Shield of Michigan and Blue Care Network website. While we recommend this site, we're required to let you know we're not responsible for its content.