Pre-Claim Review

Advance Determination of Medicare Coverage (ADMC) - View information about voluntary program that allows suppliers and beneficiaries to request prior approval of "eligible" items before item delivery

Required Prior Authorization Programs - CMS has implemented Prior Authorization (PA) as a condition of payment for specific HCPCS codes.

Pre-Claim Hotline - The Pre-Claim hotline is a service for suppliers regarding Prior Authorization and Advance Determination of Medicare Coverage (ADMC) programs.


Last Updated Aug 16 , 2023

Prior Authorization Lookup Tool

Determine which HCPCS codes require a Prior Authorization


Enter HCPCS Code: