Prior Authorization Lookup Tool

Find out if a service needs prior authorization — type a CPT or HCPCS code in the space below to get started.

Directions

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

Important notice

This tool provides general information for outpatient services performed by a participating provider. The following services always require prior authorization:

  • Elective inpatient services
  • Urgent inpatient services
  • Services from a non-participating provider

The results of this tool are not a guarantee of coverage or authorization. If you have questions about this tool or a service, call AmeriHealth Caritas Ohio Provider Services at 1-833-644-6001.