Starting June 27, updated questionnaires to open in the e-referral system

On June 27, 2021, we'll update the following questionnaires in the e-referral system:

We'll also update the corresponding preview questionnaire on the website.

As a reminder, we use our authorization criteria, our medical policies and your answers to the questionnaires in the e-referral system when making utilization management determinations on your authorization requests.

Preview questionnaires

You can access preview questionnaires at They show the questions you'll need to answer in the actual questionnaires that open in the e-referral system. This can help you prepare your answers ahead of time.

To find the preview questionnaires:

Authorization criteria and medical policies

The pertinent authorization criteria and medical policies are also available on the Authorization Requirements & Criteria page.

*CPT codes, descriptions and two-digit modifiers only are copyright 2020 American Medical Association. All rights reserved.

Posted: June 2021
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network