Submission of Requests for Prior Authorization (PA) for Certain Hospital Outpatient Department (OPD) Services

While this prior authorization process is applicable to hospital OPDs, as specified in CMS-1717-FC, CMS allows the PA request to be sent by the physician/practitioner on behalf of the hospital OPD. If a PA request submitted by the physician/practitioner includes all necessary hospital OPD information, it is considered to be sent on behalf of the hospital OPD.

Please visit our Prior Authorization for OPD Services Webpage to learn about submitting requests.


            Last Updated Tue, 18 Aug 2020 14:23:36 +0000