Blue Cross NC policy

New Specialty Pharmacy Medical Step Therapy Requirement

New Specialty Pharmacy Medical Step Therapy Requirement is a public Blue Cross NC policy (policy NCBCBS-CR-077567-25-CPN77133, effective Jun 1, 2025). Not a coverage decision; the payer's own document governs.

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Payer: Blue Cross NC
Policy number: NCBCBS-CR-077567-25-CPN77133
Effective: Jun 1, 2025
Line of business: Medicaid
Source: www.bcbsnc.com

All Blue Cross NC policies · Blue Cross NC prior authorization CPT list

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The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

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