medicaid prior authorization list

0000627155 00000 n 0000029702 00000 n ColoradoPAR is the Health First Colorado (Colorado's Medicaid Program) utilization management (UM) program. If you need more information, call Member Services toll-free at 800-462-3589. For more information on eQHealth Solutions, Inc. please visit the website. endstream endobj 25199 0 obj <>stream 0000005689 00000 n 0000005541 00000 n .�E��ə�Nx��d�vԒ +�}�� P2�,rxf�q�ۿ�~q��ylqq�~��x��6�c�K3e�->ܮK��Әյ��2��ö��1��]��~��. 0000631686 00000 n Contact Information. This list does not contain every treatment or procedure that requires prior authorization. CareSource Prior Authorization List Prior authorization is how we decide if the health services listed below will be covered by your CareSource plan. 0000651431 00000 n 02/2018 pol-mpapdl TxVendorDrug.com PAGE 1 OF 5 About • People enrolled in either traditional Medicaid (fee-for-service) or Medicaid managed care adhere to the same formulary, and some drugs on the formulary may require prior authorization, either non-preferred, clinical, or both. Medicaid Preferred Drug List . wyoming medicaid dme prior authorization list january 2019 hcpcs code hcpcs description k0738 k0739 k0740 k0800 k0801 k0802 k0806 k0807 k0808 k0813 k0814 k0815 k0816 k0820 k0821 k0822 k0823 k0824 k0825 k0826 k0827 k0828 k0829 k0830 k0831 k0835 k0836 k0837 k0838 k0839 k0840 k0841 k0842 k0843 k0848 k0849 k0850 k0851 k0852 k0853 k0854 k0855 k0856 k0857 k0858 k0859 port … 0000004729 00000 n Please call our … 78 69 h�24�47W0P��w�/�+Q040��L)�6�X e��,K0��223�b�C*R��S�� . 0000648662 00000 n hޜ�Mk�0��v�;I��KK7;�Ԥ�ׇ��/�2Ha[םl�2�N(�!��I��o� b�%d�R��q� T��uut,�V��BaTub!Aѵ.ϻ��@M��1ƾ��n��A��g�h�� [g�+��l��蔩ˬ��f[��0*�ݹ��︠�{�Yx��"IӹJ�[UїJR��Mu$~ -�G^z�=�7��d�Vf��?5I�/��C� ��ά 0000002349 00000 n WV Medicaid; Dual Eligible Special Needs Plan (D-SNP) Patient Care Programs; Advance Directives; Behavioral Health; Clinical Services Department; Pharmacy; Quality Measures; Substance Use Disorder; Telehealth Services; Population Health; Claims Support; Claims ; Fee Schedules; Payment Policies; Reconsideration & Appeals; Resources; Physician Case Management Referral; Provider … o Pharmacy prior authorization services for people enrolled in Medicaid managed care are administered by the person’s managed care organization o Traditional Medicaid prior authorizations are administered by the Texas Prior Authorization Call Center. �f These requests can be submitted by phone, fax or online, using Superior’s Secure Provider Portal. Applies to Medicaid, MyCare Ohio Medicaid Prior Authorization Codification List Effective: 1/1/2021 Important Notices about the PA Code List These codes are for outpatient services only. 0000023715 00000 n February 1, 2019 . 0000009103 00000 n Any exceptions included in this prior auth code matrix applies to PAR providers only. )S��-,��a�3ļ歶Z��H�Ed�%^�\B��N�P�e�� 0000030788 00000 n 66��y% 0000009909 00000 n 0000005787 00000 n 0000038464 00000 n 0000625145 00000 n Medicaid Pharmacy Prior Authorization & Preferred Drug List Rev. �J�o�m�b��>��i �.��)��+=��?��86W=�-͚�w9��d�a��l��C�^=unB=r��1��V)K�:A��G�}:��y�^��G`�c0�GamP�L��{R��F^��2Ǖ+:D��Ǆ-��]��L�S�b�Q�֌�~D�D�|�/7 �}�Cj�x��61Ud��u'��I&K��m�ܒ��g�b 0000006620 00000 n 0000029019 00000 n KPMAS Regional Pharmacy and Therapeutics (P&T) Committee P&T Approval/Revision Date: 11/06/2020; 9/3/2020; 6/5/2020; 12/6/2019; 10/5/2018 2. 0000005591 00000 n trailer <<85BFBDCE617F4048B8D8E596C89F2D24>]/Prev 662548/XRefStm 2026>> startxref 0 %%EOF 146 0 obj <>stream ��됸¾[ηMq��=��G��lm�Z=�:��ǿ�4N�V�� 0 �� endstream endobj 84 0 obj [/Separation/PANTONE#20158#20C 113 0 R<>] endobj 85 0 obj [/Indexed/DeviceCMYK 174 114 0 R] endobj 86 0 obj [/Indexed/DeviceCMYK 151 115 0 R] endobj 87 0 obj [/Indexed/DeviceCMYK 67 116 0 R] endobj 88 0 obj [/Indexed/DeviceCMYK 49 117 0 R] endobj 89 0 obj [/Indexed/DeviceCMYK 101 118 0 R] endobj 90 0 obj [/Indexed/DeviceCMYK 9 119 0 R] endobj 91 0 obj [/Indexed/DeviceCMYK 14 120 0 R] endobj 92 0 obj [/Indexed/DeviceCMYK 113 121 0 R] endobj 93 0 obj <> endobj 94 0 obj <> endobj 95 0 obj <> endobj 96 0 obj <> endobj 97 0 obj <>stream This list contains prior authorization requirements for care providers who participate with UnitedHealthcare Community Plan in Arizona Complete Care Medicaid (ACC) Program for inpatient and outpatient services. This is called prior authorization. The Georgia Department of Community Health establishes the guidelines for drugs requiring a Prior Authorization (PA) in the Georgia Medicaid Fee-for-Service/PeachCare for Kids® Outpatient Pharmacy Program. ��JV0}s�1�'�'�'�'�'�'Y�� tp�(�QSSSSSS�� G��__�� _�^錄�n�1��:� ��r?o�AYE�� Georgia Medicaid Prior Authorization List Prior Authorization (PA) review is needed and includes, but is not limited to, the following types of requests for both medical and behavioral health services: • All Inpatient Care • Dental procedures in a Hospital, Outpatient Facility, or Ambulatory Surgery Center for (D9420) (please 0000003741 00000 n 0000622242 00000 n Prior Authorization Rules - Medicaid Medical / Surgical (Non-Behavioral Health), continued Podiatry (foot and ankle) services Refer to the procedure code list for prior authorization requirements. Prior authorization for prescription drugs is decided within in 24 hours. h�24�4�P0P0Җ 0000005886 00000 n Prior approval is required for all services by a provider who is not in the Sunshine Health network. This list is not intended to be all-inclusive of covered services or authorization requirements under WellCare of Kentucky Health Plans, Inc.. 0000009014 00000 n It It provides information regarding prior authorization requirements that were generally accurate as of the publish date reflected on this document. 0000006488 00000 n 0000015225 00000 n The numerical … 0000636756 00000 n 0000018032 00000 n H�\��n�0E�� h�LP�n�@��I(H(RyI�"B�C��\�"�WƑ��K��by��#N��Q/�ӑ�x�ǰ��$�)��t0h��KB��dǈ�7�í�*Kl�aڇ-U�2��]�rẸi�D�e:��9#��8xc��+KG6�l�;��a��=֌-��9j��՟e��u&?5�Q��NGX��Е��U�a^]��^��c�QKд{�i��T��K��C��%v�� ]ù��O�/�Ӟ�3*��.

medicaid prior authorization list 2021