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Breaking news!: Physicians Health Plan of Northern Indiana to join Priority Health. Read more in the full media release.

Why is prior authorization important?

Prior authorization allows both the member and healthcare provider to understand coverage decisions before procedures, services, or supplies are received. This process also helps identify members for specialty programs (like case and disease management, for example) that can make the healthcare journey a more seamless experience.

What services require prior authorization?

Prior authorization occurs before any inpatient admission or service, and also for select outpatient procedures and services. Click here for a list of services that require prior authorization.

Search by Code

Use our search tool to determine if a prior authorization is required. Enter one or more five-character codes.

Top 30 Submitted CPT Codes for {{selectedYear}}

RankCPT CodeReferralsPercent Approved
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