New CPT Proprietary Laboratory Analyses (PLA) codes and CPT Category III codes will require prior authorization, unless determined to be a non-covered service, upon their effective date of 7/1/2024. See the list of the new CPT Codes that will require prior authorization.
For other established codes, please use the Pre-Auth Check Tools on our websites to confirm if the code(s) requires prior authorization. Prior authorization requirements vary based on the line of business, so please select the applicable Pre-Auth Check Tool by the line of business.
See the list of the new CPT Codes that will require prior authorization.
