Procedures Managed by eviCore for Blue Cross

For Blue Cross PPO (commercial) members
(for dates of service on or after Jan. 1, 2018)

Providers must obtain authorization from eviCore healthcare for:

  • Outpatient interventional pain management
  • Inpatient and outpatient lumbar spinal fusion surgery
  • Outpatient radiation therapy (oncology)

Refer to the resources below for more information:

For Blue Cross Medicare Plus BlueSM PPO members

Providers must obtain authorization from eviCore healthcare for:

  • Outpatient interventional pain management
  • Inpatient and outpatient lumbar spinal fusion surgery
  • Outpatient radiation therapy (oncology)
  • Outpatient physical and occupational therapy services
  • Inpatient post-acute care services (for members admitted through May 31, 2019)
  • For members admitted on or after June 1, 2019, submit post-acute care authorization requests to naviHealth. See the frequently asked questions document (PDF) for more information on this change.

Refer to the resources below for more information:


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