Prior Authorizations in Wisconsin

Prior authorization guide

Prior Authorization Details

• For Medicaid PA information, please review our Pre-Service Review Guide and Medicaid Provider Manual
• For Family Care, Family Care Partnership and Medicare Dual Advantage prior authorization information, please go to mychoicewi.org/providers/authorizations.

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.

Service Prior Authorizations

Office visits to participating 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 provider portal.

See all provider resources