July 16, 2020
Beginning November 1, 2020, Premera will review Healthcare Common Procedure Coding System (HCPCS) codes in the “C” series for medical necessity. Codes in this series may only be billed by facilities. Professional services are not reported using “C” codes.
Premera will begin reviewing “C” codes related to certain services, along with any subsequently released like HCPCS or Current Procedure Terminology (CPT) codes. We’ll keep you informed as we expand review of “C” codes to additional services. For details on monthly changes and prior authorization requirements, refer to Medical Policy and Coding Updates.