Prior Authorizations in Texas
Providers can find details about Molina’s prior authorization (PA) process, methods for submitting requests, procedures for denials and peer-to-peer reviews, as well as how to access forms and contact our team.
Service Prior Authorizations
Office visits to participating (PAR) providers and referrals to network specialists do not need Prior Authorization (PA). Emergency services also do not require authorization.
Molina requires PA for certain services. See which services need PA with the prior authorization lookup tool. Providers can request and manage authorizations via Availity Essentials.
Additional information on PA requirements is included below.
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, visit our provider pharmacy page.