Prior Authorization - JF Part B
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Prior authorization demonstration for certain services in Ambulatory Surgical Centers (ASC) in the state of Arizona will go into effect on December 15, 2025. Providers can submit prior authorization requests beginning on December 1, 2025, for dates of service on or after December 15, 2025.
Prior Authorization
Prior Authorization for Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Services - View Ambulance services that require prior authorization, the authorization process, how to submit a prior authorization request, the documentation requirements and coverage for the 2 services: A0426 - Ambulance service, advanced life support, nonemergency transport, level 1 (ALS 1); and A0428 - Ambulance service, basic life support, nonemergency transport (BLS).
Part A Prior Authorization for Certain Hospital Outpatient Department (OPD) Services
This Program applies to Part A PTAN OPD billing only. Please navigate to Noridian Medicare Part A JF > Medical Review > Prior Authorization to view outpatient department services that require prior authorization, the authorization process, how to submit a prior authorization request, and the documentation requirements and coverage for the 8 services: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, vein ablation, spinal cord neurostimulator, cervical fusion and facet joint intervention for pain management.
For questions, please contact PartApriorauth@noridian.com
Prior Authorization Lookup Tool
Determine which CPT/HCPCS codes require a Prior Authorization when performed in certain hospital OPD
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