### Medical and behavioral health policies

The Blue Cross and Blue Shield of Minnesota (Blue Cross) medical and behavioral health policy team develops evidence-based medical and behavioral health policies.

The team presents medical and behavioral health policies to the Blue Cross Medical and Behavioral Health Policy Committee and the Blue Cross Medical Pharmacy & Therapeutics Committee, which are made up of practicing physicians, pharmacists and other providers representing a variety of specialties and Blue Cross representatives.



 

[View medical and behavioral health policies](/providers/medical-management/medical-and-behavioral-health-policies)

 

 

 

 ### Prior authorization

Blue Cross requires prior authorization (PA) for some covered admissions, continued stays, services, procedures, drugs and medical devices before they’re covered.

Prior authorization is a review and approval before a service happens to determine whether it’s medically necessary and appropriate. Prior authorization needs vary by the type of health plan the member has.



 

[View prior authorization information](/providers/medical-management/prior-authorization)

 

 

 

 

 ### Medical Policy and Pre-Certification / Authorization Router

Use this tool to view an out-of-state Blue Plan's medical policy or general pre-certification / pre-authorization information.



 

[Get information from other states](http://mktg.bluecrossmn.com/router/)

 

 

 

 ### For questions about a medical policy or an appeal

**Providers:**

- Call **(651) 662-5000**
- Call **1-800-262-0820**

**Members:**

- Call the number on the back of your member ID card
- Call **(651) 662-8000**
- Call **1-800-382-2000** (TTY **711**)



 

 

 

 

 

 

Acknowledgements:

The five-digit numeric codes that appear on the documents on this site were obtained from the Physician's Current Procedural Terminology, as contained in CPT® 2022, ©2021 American Medical Association.

Current Dental Terminology, as contained in CDT 2022: Dental Procedure Codes, ©2021 American Dental Association. All rights reserved.

Prime Therapeutics LLC is an independent company providing pharmacy benefit management services.