Authorization Lookup

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


The codes contained in this list are limited to Current Procedural Terminology (CPT codes) and do 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), Diagnostic Sleep Services, Molecular and Genetic Laboratory Testing, Radiation Therapy, and Outpatient Occupational and Physical Therapy – managed by CareCore National.
  • Select Behavioral Health services.
  • Cosmetic Procedures.
  • Dialysis.
  • Home Health Care.
  • Select Pharmaceuticals.
  • Transplant services.

 

For additional information, please refer to the Quick Reference Guide.

 

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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