This page includes the prior authorization summaries and code list documents that were posted at the end of the year for the past two years.
- 2021 Commercial Prior Authorization Requirements Summary
- 2021 Commercial Outpatient Medical Surgical Prior Authorization Code List
- 2021 Commercial Specialty Pharmacy Prior Authorization Drug List
- 2020 Commercial Prior Authorization Requirements Summary
- 2020 Commercial Outpatient Medical Surgical Prior Authorization Code List
- 2020 Commercial Specialty Pharmacy Prior Authorization Drug List
Checking eligibility and benefits and/or obtaining prior authorization is not a guarantee of payment of benefits. Payment of benefits is subject to several factors, including, but not limited to, eligibility at the time of service, payment of premiums/contributions, amounts allowable for services, supporting medical documentation, and other terms, conditions, limitations, and exclusions set forth in the member’s policy certificate and/or benefits booklet and or summary plan description. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. If you have any questions, call the number on the member's BCBSIL ID card.