Medicare Part B medical specialty drug prior authorization list is changing in March

We're adding medications to the Medicare Plus BlueSM PPO and BCN AdvantageSM Part B medical specialty prior authorization drug list. These specialty medications are administered in outpatient sites of care, such as a physician's office, an outpatient facility or a member's home.

For dates of service on or after March 16, 2020, you'll need to request authorization for the following medications through the system specified below.

Through the NovoLogix® online tool

Through the AIM Specialty Health® ProviderPortalSM

How to bill

For Medicare Plus Blue and BCN Advantage, we require authorization for these medications for all outpatient sites of care when you bill the medications as a professional service or as an outpatient facility service and you bill as follows:

Important reminder

Depending on the medication, you can quickly submit authorization requests through NovoLogix or through AIM.

For information about registering for and accessing the AIM ProviderPortal, see the Frequently asked questions page on the AIM Specialty Health website*.

List of requirements

For a list of requirements related to drugs covered under the medical benefit, please see the Medical Drug and Step Therapy Prior Authorization List.

*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.

Posted: December 2019
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network