Prior Authorization Lookup Tool

Find out if a service needs prior authorization. Type a Current Procedural Terminology (CPT) code or a Healthcare Common Procedure Coding System (HCPCS) code in the space below to get started.

Important notice

This tool provides general information for outpatient services performed by a participating provider. Prior authorization requirements also apply to secondary coverage.

The following services always require prior authorization:

• Inpatient services (elective and urgent)
• Services with a non-participating provider
• Codes not on the PerformCare Fee Schedule

If you have questions about this tool or a service or to request a prior authorization, contact Utilization Management at 1-888-700-7370.

Directions

1. Enter a CPT/HCPCS code in the space below.
2. Click Submit.
3. The tool will tell you if that service needs prior authorization.