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Authorization Lookup

Please select your line of business from the drop-down menu, enter the desired CPT code, and click search


The codes contained on this list are limited to Current Procedural Terminology (CPT codes) and does not include most HCPCS codes. Separate authorization requirements may apply for HCPCS codes.

 

Authorization is required for the following services:

  • Services rendered by non-participating providers and facilities.
  • Inpatient confinements including: Elective Inpatient, Acute Inpatient, Skilled Nursing Facility, Behavioral Health, Rehabilitation and Long-term/Sub-acute care services.
  • Advanced Radiological, Diagnostic Cardiac, Musculoskeletal (Pain Management) and Diagnostic Sleep Services – managed by CareCore National.
  • Behavioral Health.
  • Cosmetic Procedures.
  • Select Durable Medical Equipment (DME) items.
  • Home Health Care.
  • Select Pharmaceuticals.
  • Skilled Therapy Services: Occupational, Physical and Speech Therapy services.
  • Transplant services.

We encourage you to verify member eligibility and confirm benefits prior to rendering services. Reimbursement for these services will be in accordance with the terms and conditions of your agreement.
 

 

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