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.

Important notice

This tool provides general information for outpatient services performed by a participating provider.
The following services always require prior authorization:

• Inpatient services (elective and urgent).
• Services with a non-participating provider (Join Our Network).
• Codes not on the Medicare Fee Schedule.

If you have questions about this tool, a service or to request a prior authorization, contact Utilization Management at 1-888-244-5410.

Directions

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