This article is for providers performing surgical services for our members
On January 1, 2023, our Inpatient Only List will take effect. This list contains codes for services that Blue Cross Blue Shield of Massachusetts only pays when care takes place on an inpatient basis for our commercial members. We are not changing authorization requirements and you can still use Authorization Manager to check if authorization is required.
The Inpatient Only list will replace the Outpatient & Surgical Day Care list currently on the Prior Auth Overview page. This change aligns with CMS.
For Medicare Advantage members, please continue to refer to CMS’ inpatient only list.