Anthem Blue Cross and Blue Shield Virginia policies

Search Anthem Blue Cross and Blue Shield Virginia's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

90867 is on the Anthem Blue Cross and Blue Shield Virginia prior authorization list. See its prior authorization entry

27 policies name 90867, those listing the fewest codes first. A policy that names a code may also list it as excluded.

Anthem Blue Cross and Blue Shield Virginia policies
Policy	Details	Codes	Source
Transcranial Magnetic Stimulation (TMS) Request Form - Commercial	Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, NY, OH, VA, WI	2	Original policy ↗
Professional Provider Manual	Effective Dec 9, 2019 · Commercial · VA	17	Original policy ↗
Professional Provider Manual	Effective Nov 1, 2019 · Commercial · VA	17	Original policy ↗
Professional Provider Manual	Effective Sep 1, 2019 · Commercial · VA	17	Original policy ↗
VIRGINIA FACILITY PROVIDER MANUAL	Effective Sep 21, 2017 · Commercial · VA	32	Original policy ↗
VIRGINIA FACILITY PROVIDER MANUAL	Effective May 1, 2017 · Commercial · VA	32	Original policy ↗
VIRGINIA FACILITY PROVIDER MANUAL	Effective Feb 1, 2018 · Commercial · VA	32	Original policy ↗
VIRGINIA FACILITY PROVIDER MANUAL	Effective Apr 1, 2018 · Commercial · VA	33	Original policy ↗
VIRGINIA FACILITY PROVIDER MANUAL	Effective Oct 23, 2019 · Commercial · VA	58	Original policy ↗
VIRGINIA FACILITY PROVIDER MANUAL	Effective May 1, 2019 · Commercial · VA	58	Original policy ↗
VIRGINIA FACILITY PROVIDER MANUAL	Effective Aug 23, 2019 · Commercial · VA	58	Original policy ↗
Anthem Blue Cross and Blue Shield Virginia Facility Provider Manual	Effective Jun 1, 2022 · Commercial · VA	90	Original policy ↗
Anthem Blue Cross and Blue Shield Virginia Facility Provider Manual	VABCBS-CM-PM-061543-24 · Effective Oct 1, 2024 · Commercial · VA	90	Original policy ↗
Anthem Blue Cross and Blue Shield Virginia Facility Provider Manual	Effective Jul 1, 2023 · Commercial · VA	90	Original policy ↗
Anthem Blue Cross and Blue Shield Virginia Facility Provider Manual	Effective Dec 1, 2023 · Commercial · VA	90	Original policy ↗
Anthem Blue Cross and Blue Shield Virginia Facility Provider Manual	VABCBS-CM-PM-061543-24 v1.07012024 · Effective Jul 1, 2024 · Commercial · VA	90	Original policy ↗
Virginia Facility Provider Manual	VABCBS-CM-PM-086206-25 · Effective Aug 1, 2025 · Commercial · VA	90	Original policy ↗
Virginia Facility Provider Manual Revised August 1, 2024	VABCBS-CM-PM-061543-24 v2A.08152024 · Effective Aug 1, 2024 · Commercial · VA	90	Original policy ↗
2026 Virginia Facility Commercial Provider Manual	VA-BCBS-CM-PM-013594-26-S3776 · Effective Jul 1, 2026 · Commercial · VA	91	Original policy ↗
Anthem Blue Cross and Blue Shield Virginia Facility Provider Manual	Effective Jul 1, 2021 · Commercial · VA	93	Original policy ↗
Virginia Professional Provider Manual	Effective Sep 24, 2020 · Commercial · VA	113	Original policy ↗
Virginia Professional Provider Manual	VABCBS-CM-PM-086207-25 · Effective Dec 1, 2025 · Commercial · VA	139	Original policy ↗
Anthem Blue Cross and Blue Shield Virginia Professional Provider Manual	Effective Oct 1, 2021 · Commercial · VA	140	Original policy ↗
Anthem Blue Cross and Blue Shield Virginia Professional Provider Manual	Effective Mar 1, 2023 · Commercial · VA	141	Original policy ↗
Virginia Professional Provider Manual	Effective Oct 1, 2024 · Commercial · VA	141	Original policy ↗
Virginia Professional Provider Manual	Effective Dec 1, 2023 · Commercial · VA	141	Original policy ↗
Virginia Professional Provider Manual	VABCBS-CM-PM-072981-24 · Effective Mar 1, 2025 · Commercial · VA	143	Original policy ↗

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