September 2024 Medical and Pharmacy Policy updates now available
June 1, 2024
Special reminder about transcranial magnetic stimulation
As previously communicated, we’ll require prior authorization for transcranial magnetic stimulation as a treatment of depression for commercial PPO members starting on July 1, 2024. The authorization will apply to CPT codes:
As previously communicated, we’ll require prior authorization for transcranial magnetic stimulation as a treatment of depression for commercial PPO members starting on July 1, 2024. The authorization will apply to CPT codes:
- 90867
- 90868
- 90869
We already require authorization today for our commercial and Medicare Advantage members for this service as part of medical policy 297: Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric/Neurologic Disorders.
We’ve posted new, revised, clarified, and retired medical and pharmacy medical policies, effective in September 2024.
Medicare Advantage policies
Medical policy
132, Medicare Advantage Management
(This document explains whether we use CMS criteria—or our own—to make coverage determinations for our Medicare Advantage members.)
Medicare Advantage section of our medical policy site.
FEP medical policies
Visit fepblue.org and search for medical policies.
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