Nov. 26, 2025
We’re updating prior authorization requirements for hospice services for members with Blue Cross Community Health PlansSM, effective Jan. 1, 2026.
What’s changing: You’ll need a signed Certification of Terminal Illness Form included in your prior authorization submission. Any request received without the signed CTI Form will be returned or denied.
Important reminders: Always check eligibility and benefits through Availity® Essentials or your preferred vendor prior to rendering services. This step will confirm prior authorization requirements and utilization management vendors, if applicable.
Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to Blue Cross and Blue Shield of Illinois. BCBSIL makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them.