News and updates

Effective July 1, 2026, PacificSource will implement updates to its policies regarding hospital outpatient observation services. Key considerations when billing for these services include the...

Updates on Existing CriteriaMay 2026. The following changes to criteria are effective by May 22, 2026:Prior Authorization Criteria –...

Updates on Existing CriteriaApril 2026. The following changes to criteria are effective by April 9, 2026:Prior Authorization Criteria...

Updates on Existing CriteriaThe following changes to criteria are effective by February 22, 2026:Prior Authorization Criteria – Clinical Updates...

Medicare:Starting February 1, 2026, these services with the listed billing codes will require prior authorization.C9781 - Arthroscopy, shoulder, surgical;...