Prior Authorization Lookup Tool
Find out if a service needs prior authorization. Type a Current Procedural Terminology (CPT) code in the space below to get started.
- Enter a CPT/HCPCS code in the space below.
- Click Submit.
- The tool will tell you if that service needs prior authorization.
This tool provides general information for outpatient services performed by a participating provider.
The following services always require prior authorization:
- Elective inpatient services.
- Urgent inpatient services.
- Services from a nonparticipating provider.
The results of this tool are not a guarantee of coverage or authorization. If you have questions about this tool or a service, call 1-833-435-8600 or fax to the appropriate number below:
- Physical Health 1-833-435-3290.
- Behavioral Health: 1-833-329-3529.