Commercial and Medicaid:
Starting January 1, 2026, these services with the listed billing codes will require prior authorization for both Commercial and Medicaid plans:
- 33249
- 33285
- 93454
- 93456
- 93458
- 93460
Please check codes using our Provider Authorization Grid tool prior to services being rendered.
Medicaid:
Starting January 1, 2026, services with the following CPT/HCPC codes will require prior authorization for Medicaid plans:
- 21120
- 21121
- 21122
- 21123
- 21199
- 29999
- 30520
- 31599
- 31899
- 39599
- 43659
- 47379
- 49329
- 50949
- 51999
- 60699
- 64999
- 78499
- E0849
Starting January 1, 2026, services billed for Medicaid members with the following HCPC codes will require prior authorization if the cost of the item is greater than $500:
- L8699
- L1499
- E1399
- L7499
- L2999
Please check codes using our Provider Authorization Grid and LineFinder tools prior to services being rendered.