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New Prior Authorization Requirement for FEP Blue Basic and FEP Blue Standard Options – Effective Jan. 1

Effective Jan. 1, 2026, the Federal Employee Program (FEP) will require prior authorization for elective non-urgent outpatient orthopedic surgical procedures involving the hip, knee and spine for FEP Blue Standard and FEP Blue Basic Option members. This requirement is already in place for FEP Blue Focus members and is now being extended to include FEP Blue Standard and FEP Blue Basic.

Key Details:

  • Applies to: Elective non-urgent outpatient procedures on the hip, knee and spine.
  • Effective Date: Jan. 1, 2026.
  • FEP Options Impacted: FEP Blue Basic and FEP Blue Standard (FEP Blue Focus remains unchanged).
  • Inpatient procedures: Already require precertification — no change.
  • Process: Providers should continue to follow existing prior authorization procedures. Claims without prior authorization will be subject to medical necessity review upon adjudication.

If you have any questions, contact your Blue Cross and Blue Shield of Kansas (BCBSKS) provider relations representative.