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 ManualOpens a new window (PDF).

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

Find out if a service needs prior authorization. Type a Current Procedural Terminology (CPT) code in the space below 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.