Prior Authorization Code by State

Arizona

• Arizona Complete Care Prior Auth Code List
• Prior Authorization Requirements for Developmentally Disabled Arizona Members
• Arizona Long Term Care Prior Auth Code List

Colorado

• Colorado Prior Authorization and Notification

District of Columbia

• District of Columbia Medicaid Prior Auth Code List – Sept 2023

Florida

• Florida MMA Prior Auth Code List – Sept 2023

Hawaii

•  Hawaii Statewide Medicaid Managed Care Prior Auth code List – Jan 2024

Indiana

• Indiana Medicaid Hoosier Care Connect – Jan 2024

Kansas

• Kansas LTC Prior Authorization List – Jan 2024
• Kansas Medicaid Prior Authorization List – Jan 2024

Kentucky

• Kentucky Medicaid Prior Auth Code List – Sept 2023

Louisiana

• Louisiana Medicaid Managed Care Prior Auth Code List - Sept 2023

Massachusetts

• Massachusetts OneCare Prior Auth Code List – Sept 2023

Minnesota

• Minnesota Managed Care Prior Auth Code List - Sept 2023
• Minnesota Senior Care Plus (MSC+) Prior Auth Code List - NOV 2023
• Minnesota Special Needs Basic Care (SNBC) Prior Auth Code List - Sept 2023

Mississippi

• Mississippi CAN Prior Auth Code List – Sept 2023
• Mississippi CHIP Prior Auth Code List - Sept 2023

Missouri

• Missouri HealthNet Prior Auth Code List – Sept 2023

Nebraska

• Nebraska Heritage Medicaid Prior Auth Code List – Sept 2023

New Jersey

• List not available at this time

New York

• New York Child Health Plus CHP Prior Auth Code List – Sept 2023
• New York EPP Prior Auth Code List – Sept 2023
• New York HARP Prior Auth Code List – Sept 2023
• New York Mainstream Medicaid over 21 Prior Auth Code List – Sept 2023
• New York Mainstream Medicaid under 21 Prior Auth Code List – Sept 2023
• New York mainstream Medicaid under 21 IN Foster Care Auth Code List – Sept 2023

North Carolina

• North Carolina Prior Auth Code List – Sept 2023

Ohio

• Ohio Medicaid Prior Auth Code List – Jan 2024
• Ohio MMP Prior Auth Code List – Sept 2023

Pennsylvania

• Pennsylvania CHIP Prior Auth Code List – Sept 2023

Rhode Island

• Rhode Island Ritecare, Rhody Health Partners, CSN & ACA Prior Auth Code List – Sept 2023

Tennessee

• Tennessee TennCare and Cover Kids Prior Auth Code List - Sept 2023

Texas

• Texas CHIP Prior Auth Code List - Sept 2023
• Texas Star Kids Prior Auth Code List - Sept 2023
• Texas Star Plus Prior Auth Code List - Sept 2023
• Texas STAR Prior Auth Code List - Sept 2023

Virginia

• Virginia CCC Plus Prior Auth Code List – Sept 2023
• Virginia Medallion 4 Prior Auth Code List – Sept 2023

Washington

• Washington Integrated Managed Care (IMC) Medicaid Prior Auth Code List – Sept 2023

Wisconsin

• Wisconsin Medicaid Prior Auth Code List – Sept 2023