Prior Authorization Lookup Tool

Important notice

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 non-participating provider

The results of this tool are not a guarantee of coverage or authorization. All results are subject to change in accordance with plan policies and procedures and the Provider Manual (PDF).

If you have questions about this tool or a service, or would like to request a prior authorization, call 1-800-521-6622.

Find out if a service needs prior authorization. Type a CPT code into the tool to get started.

Directions

1. Enter a CPT code in the space below.
2. Click Submit.
3. The tool will tell you if that service needs prior authorization.