Prior Authorization Tool

How to search:

Begin by selecting the correct plan.

Start the search by typing the first two characters of the procedure code or description. Results will display beginning with the characters you entered. Refine the search further by entering additional characters. Only 10 codes will display at a time.

Results are displayed as: “Procedure Code”, “Description”, “Effective Date”, “Authorization Required” and “Exception”. N/A will appear for all Procedure Codes that do not carry an exception. If you receive “undefined” results, please check your code/description and try again.

Rev Codes are best found by searching by description, i.e. 'NURSING' for Rev Code 550, etc.

Begin a new search by erasing the characters in the search box or pressing New Search button.