Preauthorization Lists
The services or drugs on these lists may require preauthorization 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 Availity® 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.
Fully Insured Plans
Commercial Procedure Code Look Up 2021 - Updated 3/1/2021 (Excel Document)
Current Preauthorization Requirements (Commercial) Effective 1/1/2021 (PDF Document)
2021 Commercial Medical Surgical Preauthorization Code List - Updated 3/1/2021 (PDF Document)
2021 Specialty Drugs and Infusion Site of Care Preauthorization Code List - Updated 2/1/2021 (PDF Document)
2021 Behavioral Health Preauthorization Code List - Updated 3/1/2021 (PDF Document)
Note: Changes reflect updates based on American Medical Association (AMA) code changes to add, revise or remove codes.