Prior authorization guide
Important update for providers:
Starting 2/1/26, providers must submit medical benefit PA requests through Availity Provider Portal as Molina no longer accepts fax submissions. Continue to follow the current pharmacy submission processes for pharmacy benefit PA requests; do not submit these through the Availity Provider Portal.
Service Prior Authorizations
Office visits to participating (PAR) providers and referrals to network specialists do not need prior authorization. Emergency services also do not require authorization.
Molina requires PA for certain services. See which services need prior authorization with the PA Look Up Tool. Providers can request and manage authorizations via Availity Provider Portal.
PT/OT/ST Reminder:
Effective June 1, 2026, all Physical Therapy, Occupational Therapy, and Speech Therapy (PT/OT/ST) will require a Prior Authorization (PA) after 6 visits per rolling year. Providers should utilize the Availity Provider Portal for PA electronic submission for faster turnaround time.
For any general provider inquiries, please contact the Provider Services Contact Center at (844) 236-1464, or email our Provider Relations Team at IAProviderRelations@MolinaHealthcare.com.
Pharmacy Prior Authorizations
Molina attempts to provide appropriate and cost-effective drug therapy to all members covered by the Molina pharmacy program. If a member requires medication that does not appear on the formulary, the physician can make a request for a non-preferred medication.
For more information on pharmacy prior authorization:
Prior Authorization Request Forms
Prior Authorization Medications Forms
Prior Authorization Look Up Tool (located near bottom of Iowa Provider home page)