April 8, 2020

Extending Prior Authorization on Previously Approved Elective Surgeries, Procedures and Therapies

Blue Cross and Blue Shield of New Mexico (BCBSNM) is temporarily extending approvals on services with existing prior authorizations until Dec. 31, 2020. This applies to services that were originally approved or scheduled between Jan. 1 and April 1, 2020. This is for most non-emergent, elective surgeries, procedures, therapies and home visits. 

What’s new: A member may reschedule an approved procedure to a later date within 2020 without a new prior authorization. This applies only to current members for a benefit that is covered under their plan at the time services are rendered.


Impacted members: This applies to all group, fully insured, self-funded, retail and Medicare Advantage members.

Medicaid and MMAI plans’ prior authorization will be extended according to those plan rules.

Additional services or sessions: For additional services or sessions, providers must submit a new prior authorization request.