Blue Cross and Blue Shield of Oklahoma – Medicare Plans Provider Resources
Providers should contact EviCore to obtain Pre-Certifications for services listed below. Services performed without a pre-authorization may be denied for payment, and the rendering provider may not seek reimbursement from the member.
Medical Oncology CPT codes no longer require pre-authorization through EviCore as of 1/1/2024. Please refer to the Provider News/Updates notice at BCBSOK.com for a list of codes that require authorization through BCBSOK as of 1/1/2024. If you have any questions, please contact BCBSOK using the number on the back of the member’s ID card.
Radiation Oncology CPT codes no longer require pre-authorization through EviCore as of 1/1/2024. Please refer to the Provider News/Updates notice at BCBSOK.com for a list of codes that require authorization through BCBSOK as of 1/1/2024. If you have any questions, please contact BCBSOK using the number on the back of the member’s ID card.
Medicare Membership:
Blue Cross Medicare Advantage (HMO) SM
Blue Cross Medicare Advantage (HMO-POS) SM
Blue Cross Medicare Advantage (PPO) SM
Oklahoma Individual Medicare HMO
Oklahoma Individual Medicare PPO
Oklahoma Group Medicare PPO
Providers should contact EviCore to obtain Pre-Certifications for services listed below. Services performed without a pre-authorization may be denied for payment, and the rendering provider may not seek reimbursement from the member.
Obtain Authorization for:
Ultrasounds do not require pre-authorization as of 7/1/2023. Should you have any questions, please contact BCBSOK using the number on the back of the member's ID card. Please see the code lists located at evicore.com for codes managed by EviCore.
Effective 9/1/2019, ST, OT, PT, Chiropractic and Cardiovascular services are no longer in scope for management by EviCore. Please see the code lists located at evicore.com for codes managed by EviCore.
Lab Management Solutions-Molecular and Genomic Lab Testing
Musculoskeletal Services
Joint Surgery (Outpatient/Inpatient)
Spine Surgery (Outpatient/Inpatient)
Interventional Pain (Outpatient)
Outpatient Advanced Radiology Imaging
Outpatient Sleep
Outpatient Specialty Drug
Musculoskeletal
Radiology
Sleep
Laboratory Management
Medical Specialty Drugs
Need Help?
Registration Instructions
EviCore highly recommends providers take full advantage of the online capabilities at https://www.evicore.com/provider
Here you can request prior authorization, review our nationally accepted evidence-based guidelines, and receive announcements about program updates. Access requires only your email address and a brief registration.