Prior authorization requirements for listed medical policies and procedure codes
This document lists medical policies and associated procedure/drug codes that require prior authorization when performed in outpatient settings (and precertification when inpatient) for Blue Cross Blue Shield of Massachusetts providers and facilities.
No material clinical or coverage changes in this revision.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.