Horizon Provider Resources

Effective November 16, 2026, Horizon NJ Health will implement a Musculoskeletal Program for Pain Management Services, managed by EviCore by Evernorth (EviCore) LLC.

Similar to our existing Horizon BCBSNJ Musculoskeletal Program for Pain Management Services, as part of this new Horizon NJ Health program, EviCore will perform utilization management and prior authorization (PA) reviews for certain Interventional Pain services for patients enrolled in our:

• NJ FamilyCare (Medicaid) plans
• Horizon NJ TotalCare (HMO D-SNP) plans
• Managed Long Term Services & Supports (MLTSS) program

For more information including the full announcement, please click HERE

Effective June 1, 2026, EviCore by Evernorth will expand its administration of utilization management programs with Horizon Blue Cross Blue Shield of New Jersey and Braven Health℠ to include certain gastroenterology (GI) services. Learn more.

Effective June 1, 2026, EviCore by Evernorth will administer an expanded scope of Horizon Blue Cross Blue Shield of New Jersey’s existing radiology/imaging program to include certain high-tech radiology services. Learn more.

EviCore by Evernorth currently provides authorization services for Radiology, Cardiology, Radiation Therapy, and Laboratory Management for Horizon Blue Cross Blue Shield of New Jersey, members enrolled in NJ FamilyCare, Horizon NJ TotalCare (HMO SNP), & Managed Long Term Services and Supports (MLTSS) for Radiology, Cardiology, and Radiation Therapy services.

Horizon Blue Cross Blue Shield of New Jersey is an independent licensee of the Blue Cross Blue Shield Association.