eviCore-Managed Procedures

For Blue Cross commercial members

Providers must obtain authorization from eviCore® healthcare for:

  • Outpatient radiation therapy (oncology)
  • Outpatient interventional pain management – For dates of service from Jan. 1, 2018, through Dec. 31, 2020. You can submit retrospective authorization requests to eviCore through April 30, 2021.

    For dates of service on or after Jan. 1, 2021, submit authorization requests for pain management procedures to TurningPoint Healthcare Solutions, LLC. See the Blue Cross Musculoskeletal Services page for more information.
  • Inpatient and outpatient lumbar spinal fusion surgery – For dates of service from Jan. 1, 2018, through Dec. 31, 2020. You can submit retrospective authorization requests to eviCore through April 30, 2021.

    For dates of service on or after Jan. 1, 2021, submit authorization requests for lumbar spinal fusion surgeries to TurningPoint Healthcare Solutions, LLC. See the Blue Cross Musculoskeletal Services page for more information.

Refer to the resources below for more information:

For Medicare Plus BlueSM members

Providers must obtain authorization from eviCore healthcare for:

  • Outpatient radiation therapy (oncology)
  • Outpatient physical and occupational therapy services
  • Outpatient interventional pain management – For dates of service from Sept. 1, 2016, through Dec. 31, 2020. You can submit retrospective authorization requests to eviCore through April 30, 2021.

    For dates of service on or after Jan. 1, 2021, submit authorization requests for pain management procedures to TurningPoint Healthcare Solutions, LLC. See the Blue Cross Musculoskeletal Services page for more information.
  • Inpatient and outpatient lumbar spinal fusion surgery - For dates of service from Sept. 1, 2016, through Dec. 31, 2020. You can submit retrospective authorization requests to eviCore through April 30, 2021.

    For dates of service on or after Jan. 1, 2021, submit authorization requests for lumbar spinal fusion surgeries to TurningPoint Healthcare Solutions, LLC. See the Blue Cross Musculoskeletal Services page for more information.

Refer to the resources below for more information:

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