Prior Authorization Guide

The Medicaid Prior Authorization Guide is a listing of codes that allows contracted providers to determine if a prior authorization is required for a health care service and the supporting documentation requirements to demonstrate the medical necessity for a service. The Medicaid Prior Authorization Guide may be subject to change at any time. Please see current effective date of this guide.

Prior Authorization Guide:

1251-1910 Medicaid Prior Auth by CPT Code Guide Effective 7.1.2019