Auth Requirement Updates

01.28.2025 Exceeds Benefits Referral Reason

02.25.25 Authorization Requirement Updates- Pharmacy Services: fosaprepitant (focinvez)

02.25.25 Authorization Requirement Updates - Pharmacy Services: tocilizumab-bavi (tofidence) and micafungin

02.27.2025 Therapy Treatments Authorization Requirement_Prior Auth Always Required

03.13.2025 Authorization Requirement Updates - CFP Services

03.13.2025 Authorization Requirement Updates - Pharmacy_DME_and Other Services

03.13.2025 Authorization Requirement Updates - Behavioral Health and DME Services

03.24.2025 Authorization Requirement Updates - Pharmacy

03.24.2025 Authorization Requirement Updates - Therapy

05.12.2025 Authorization Requirement Update - Pharmacy_Wound Care_Gen Surgery Services

05.12.2025 Authorization Requirement Updates - Pharmacy_Rad Therapy_Podiatry Services

05.13.2025 High-Cost Clinician Administered Drugs (HCCAD)

06.02.2025 Auth Requirement Updates - Pharmacy_Fam Plan_Audiology_EM_DME_OBMFM_Skills Training Services

06.02.2025 Auth Requirement Update - Gen Surg_DME_Skin Sub_Oculoplastics_Med Transpo_OBMFM_Home Health Services

06.04.2025 Incontinence Supply Requests

06.13.2025 Authorization Requirement Updates - Trevimbra

06.13.2025 Authorization Requirement Updates Dual-Function Home Ventilator

06.13.2025 Important Compliance Reminder (Incontinence Supply Quantities)

06.18.2025 Authorization Requirement Updates_No Auth Required Procedure Codes

06.26.2025 Update on Authorization Requirement - PT Treatment Status Post Select Orthopedic Procedures

07.11.2025 Authorization Requirement Updates - DME_Pharmacy Services

07.11.2025 Authorization Requirement Updates - DME_Hematology Services

07.18.2025 Authorization Requirement Updates - Clinician Administered Drugs_DME

07.18.2025 Authorization Requirement Updates - Clinician Administered Drugs

08.06.2025 Medical Necessity Guidelines

08.21.2025 Procedure Codes Which Do Not Require Prior Auth

08.25.2025 Attention Texas Flood Authorization and Appeal Extensions

09.02.2025 Attention Lost or Irreparably Damaged DMEPOS During Central Texas Flooding

09.17.2025 Authorization Requirement Updates Clinician Administered Drugs - Requiring Prior Authorization

09.17.2025 Authorization Requirement Updates Clinician Administered Drugs

09.19.2025 Authorization Requirement Updates - Cardiovascular Service_Gastroenterology Service

09.19.2025 Authorization Requirement Updates - Transplant Services_Radiology Services_Orthopedic Service_MFM Service

09.23.2025 Authorization Requirements Updates - Hematopoietic Injections

10.01.2025 Authorization Requirement Update_PDN & UA Modifier Requirement Effective 11.01.2025

10.01.2025 Attention Procedure codes exceeding benefit limit

10.09.2025 Authorization Requirement Updates - Pharmacy, DME, Orthosis, Urology

10.09.2025 Authorization Requirement Updates Pharmacy, Radiology, DME

10.22.2025 Authorization Process Update_Therapies

10.23.2025 Authorization Requirement Updates (Pharmacy, DME no auth)

10.23.2025 Authorization Requirement Updates (Pharmacy, DME PA required)

11.18.2025 Authorization Requirement Updates_Vaccines

12.15.2025 Authorization Requirement Updates_Pharmacy_DME_Wound Care Services

12.15.2025 Authorization Requirement Update_Pharmacy Services

01.13.2026 Authorization Requirement Updates_Pharmacy Services

01.13.2026 Authorization Requirement Updates_Therapy Services

01.21.2026 Authorization Requests for Newborns

01.26.2026 Authorization Requirement Updates_Pharmacy_Therapy_DME Services

01.26.2026 Authorization Requirement Updates_Cardiology Services