| MED.00151 Gene Therapy for Aromatic L-Amino Acid Decarboxylase Deficiency | MED.00151 · Commercial | 4 | Original policy ↗ |
| MED.00120 Gene Therapy for Ocular Conditions | MED.00120 · Commercial | 5 | Original policy ↗ |
| MED.00135 Gene Therapy for Hemophilia | MED.00135 · Commercial | 6 | Original policy ↗ |
| Anesthesia Services - Professional | C-09002 · Effective Apr 1, 2026 · Commercial · CA | 33 | Original policy ↗ |
| Anesthesia Services – Professional | C-09002 · Effective Mar 11, 2026 · Commercial · ME | 33 | Original policy ↗ |
| Anesthesia Services – Professional | C-09002 · Effective Mar 11, 2026 · Commercial · CO, CT, GA, IN, KY, MO, NH, NV, OH, WI | 33 | Original policy ↗ |
| Anthem Blue Cross and Blue Shield Provider and Facility Manual | Effective Feb 1, 2019 · Commercial · CO | 97 | Original policy ↗ |
| Anthem Blue Cross and Blue Shield Provider and Facility Manual | Effective Feb 1, 2019 · Commercial · NV | 99 | Original policy ↗ |
| Anthem Blue Cross and Blue Shield Provider and Facility Manual | Effective Jul 1, 2017 · Commercial · CO | 104 | Original policy ↗ |
| Anthem Blue Cross and Blue Shield Provider and Facility Manual | Effective Jul 1, 2017 · Commercial · NV | 104 | Original policy ↗ |
| Anthem Blue Cross and Blue Shield Provider and Facility Manual | Effective Aug 1, 2016 · Commercial · CO | 116 | Original policy ↗ |
| Anthem Blue Cross Facility Provider Manual | Effective Mar 1, 2017 · Commercial, Medicaid · CA | 121 | Original policy ↗ |
| Medicare Advantage 2017 Precertification Requirements | Effective Jan 1, 2017 · CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | 132 | Original policy ↗ |
| Medicare Advantage 2018 Precertification Requirements | Effective Jan 1, 2018 · CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | 158 | Original policy ↗ |
| Medicare Advantage Precertification Requirements – 2019 | CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI | 191 | Original policy ↗ |
| Bundled Services and Supplies - Professional | C-08003 · Effective Dec 1, 2025 · Commercial · VA | 341 | Original policy ↗ |
| Bundled Services and Supplies - Professional | C-08003 · Effective Jul 1, 2026 · Commercial · CA | 341 | Original policy ↗ |
| Bundled Services and Supplies - Professional | C-08003 · Effective Jan 1, 2027 · Commercial · CA | 360 | Original policy ↗ |
| Bundled Services and Supplies - Professional | C-08003 · Effective Jun 24, 2026 · Commercial · CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI | 390 | Original policy ↗ |
| SHBP Prior Authorization Code List | Commercial · GA | 1,299 | Original policy ↗ |
| SHBP Medical Policies & Clinical Guidelines Precertification Code List | Effective Jan 1, 2022 · Commercial · GA | 2,220 | Original policy ↗ |
| SHBP Prior Authorization Requirements | Commercial · GA | 2,569 | Original policy ↗ |
| Standard Local Prior Authorization Code List | Commercial · GA | 3,068 | Original policy ↗ |
| California PPO Prior Authorization List | Commercial · CA | 3,545 | Original policy ↗ |