This page includes the commercial prior authorization summaries and code lists that were posted as of the end of the year for the past two years.
2025
- 2025 Commercial Prior Authorization Requirements Summary
- 2025 Commercial Outpatient Medical Surgical Prior Authorization Code List
- 2025 Commercial Specialty Pharmacy Prior Authorization Drug List
- 2025 Commercial Outpatient Behavioral Health Prior Authorization Code List
2024
- 2024 Commercial Prior Authorization Requirements Summary
- 2024 Commercial Outpatient Medical Surgical Prior Authorization Code List
- 2024 Commercial Specialty Pharmacy Prior Authorization Drug List
- 2024 Commercial Outpatient Behavioral Health Prior Authorization Code 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.