Prior Authorization Code by State
Arizona
- Arizona Complete Care Prior Auth Code List - Dec 2024
- Prior Authorization Requirements for Developmentally Disabled Arizona Members - Dec 2024
- Arizona Long Term Care Prior Auth Code List
Colorado
District of Columbia
Florida
Hawaii
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
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
Missouri
Nebraska
New Jersey
- New Jersey Family Care Prior Auth Code List - May 2024
- New Jersey DDML Prior Auth Code List - May 2024
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
Ohio
Pennsylvania
Rhode Island
Tennessee
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
Wisconsin
Wyoming
Previous Prior Authorization Lists
2024
- Arizona Complete Care Prior Auth Code List - Effective Oct. 1, 2023 - Dec. 11, 2024
- Prior Authorization Requirements for Developmentally Disabled Arizona Members - Effective Oct. 1 - Dec. 11, 2023
- Hawaii Statewide Medicaid Managed Care Prior Auth code List – Effective Aug. 1, 2023 - Dec. 11, 2024