Prior Authorization

Prior Authorization for Certain Hospital Outpatient Department (OPD) Services - View outpatient department services that require prior authorization, the authorization process, how to submit a prior authorization request, 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.

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).

 

Last Updated Jan 03 , 2024

Prior Authorization Lookup Tool

Determine which HCPCS codes require a Prior Authorization

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