Providers' News

FEP Adds New Policy for Low-Back Pain Imaging Studies
On January 1, 2023, a new policy for low-back pain X-ray imaging studies will go into effect for Federal Employee Program (FEP) members. You should read the upcoming policy change before ordering an X-ray imaging study for FEP members with a principal diagnosis of uncomplicated lower back pain. You can also read a letter from our Chief Medical Officer Mark Jansen, M.D., who discusses the need for the policy change.

Fully-Insured Prior Authorization List Changes
As of April 1, 2023, the list of services that require Prior Authorization (PA) for our fully-insured business will be changing. Please refer to the Fully-Insured Prior Authorization list for codes and requirements. Please note that the PA list for self-funded groups will remain the same for 2023 (unless we notify you in advance). For questions, please call customer service. Please submit your request through Availity to determine if PA is required.