This page provides information about home health care for Blue Cross commercial and Medicare Plus BlueSM members.
See the BCN Home Health Care page for information specific to Blue Care Network commercial and BCN AdvantageSM members.
Blue Cross commercial
Blue Cross doesn't require authorization for home health care. For information about home health care for Blue Cross commercial members, see the Home health care chapter of the Blue Cross PPO Provider Manual.
To access chapters of the Blue Cross PPO Provider Manual, log in as a provider at bcbsm.com, click the BCBSM Provider Publications and Resources link and then click Provider Manual.
Medicare Plus Blue
- For episodes of care that start and end prior to June 1, 2021: Medicare Plus Blue doesn't require authorization for home health care services.
- For episodes of care that start prior to June 1, 2021, and extend through or beyond June 1, 2021: Providers must request authorization through CareCentrix in the following situations:
- Recertification is needed
- Resumption of care is needed
- Significant change in condition occurs
- For episodes of care that start on or after June 1, 2021: Providers must request prior authorization through CareCentrix®.
Home health care agencies can submit prior authorization requests to CareCentrix starting on May 28, 2021.
For more information about the CareCentrix home health care program, see the resources below.
Resources and forms for CareCentrix:
- Home health care: Frequently asked questions for providers (PDF)
- Home health care: Quick reference (PDF)
- Home-based services: For chronic condition monitoring and surgical decision support and for authorization determinations (PDF)
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