Auth Requirement Updates

09.05.2024 Attention Provider Portal Update - New Referral Type

09.16.2024 Authorization Requirement Updates - Pharmacy Services

10.01.2024 In Lieu of Services Provider Education

10.01.2024 Authorization Requirement Updates for Behavioral Health Services_In Lieu of Services

10.01.2024 Authorization Requirement Update - Therapy Re-evaluations

10.01.2024 Authorization Requirement Updates_Wound Care Services

10.03.2024 Medical Necessity Guidelines Update - Behavioral Health and Substance Use Disorder Non-Covered Benefit Process

10.09.2024 Authorization Requirement Updates - Pharmacy and Allergy Services

10.23.2024 Authorization Requirement Updates - Pharmacy, DME, and Home Infusion Services

10.23.2024 Authorization Requirement Updates - COVID-19 Vaccines

11.01.2024 Authorization Requirement Update - Therapy Re-evaluations, Resend

11.04.2024 Authorization Requirement Updates - Therapy & Pharmacy

11.15.2024 Authorization Requirement Updates for Behavioral Health Services_In Lieu of Services - 2nd Notification Part 1

11.15.2024 Authorization Requirement Updates for Behavioral Health Services_In Lieu of Services - 2nd Notification Part 2

12.12.2024 Authorization Requirement Updates - DME and Infusion Services

12.12.2024 Authorization Requirement Updates - Pharmacy and DME Services

01.08.2025 Authorization Requirement Updates - Pharmacy Services - Procedure Code J0889

01.17.2025 Authorization Requirement Updates Observation and OB Observation Stays

01.17.2025 Authorization Requirement Updates Pharmacy and Sleep Study Services

01.17.2025 Authorization Requirement Updates Lab Services_COVID_Lumbar Punctures

01.24.2025 Authorization Requirement Updates - Pharmacy_Rad Therapy_& Hem.Onc Services

01.24.2025 Authorization Requirement Updates - Cardiology_Radiology_Lab_Surgical_& SUD services

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