The services or drugs on these lists may require prior authorization by us, eviCore Healthcare® or AIM Specialty Health® (AIM). These lists are not exhaustive and are not necessarily covered under the member benefits contract. Lists are updated quarterly to comply with AMA and CMS guidelines.
Consult or your preferred vendor for eligibility and benefits, the member/participant benefit booklet or contact a customer service representative to determine coverage for a specific medical service.
Digital Lookup Tool (For Fully Insured Only)
Review categories below to find out if a member’s procedure may require prior authorization.
2022 Fully Insured Plans
Commercial Procedure Code Look Up 2022 - Updated 5/1/2022 (Excel Document)
2021 Fully Insured Plans
Note: Changes reflect updates based on American Medical Association (AMA) code changes to add, revise or remove codes.