Prior Authorization Lookup Tool
Find out if a service needs prior authorization. Type a Current Procedural Terminology (CPT) code or a Healthcare Common Procedure Coding System (HCPCS) code in the space below to get started.
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. 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 want to request prior authorization, call 1-855-294-7046.
- Enter a CPT code in the space below.
- Click “Submit.”
- The tool will tell you if that service needs prior authorization.