Transplant Services

Resources

Blue Cross Blue Shield of Michigan and Blue Care Network manage prior authorizations for solid organ and bone marrow transplant procedures through the Human Organ Transplant Program for:

Blue Cross commercial members
BCN commercial members

Notes:

Cornea and skin transplants don’t require prior authorization.
For BCN Advantage^℠ members, transplants don’t require prior authorization through the Human Organ Transplant Program for dates of service on or after Jan. 1, 2024.
For Medicare Plus Blue^℠ members, transplants don’t require prior authorization through the Human Organ Transplant Program.

For information about entering the prior authorization request for the transplant procedure, see the e-referral User Guide. The pertinent information is in "Section IV: Referrals and Authorizations," in the subsection titled "5. Submit an Outpatient Authorization."

Note: Before submitting a request for a kidney-only transplant, call Provider Inquiry as follows to determine whether the member requires prior authorization:

Michigan hospitals and facilities: Call 1-800-249-5103.
Non-Michigan hospitals and facilities: Call 1-800-676-2583.

How to submit prior authorization requests

To learn how to submit requests, see our Getting Started page.

Submit requests before providing services.

Utilization Management Criteria

Visit our Utilization Management Criteria page.