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Public policy research · US

Does this service require prior authorization?

Check a procedure against payer policies. Review the source and verification date before acting.

Requirements vary by plan and state. Do not enter patient information.

Enter a code to start a check.

An answer needs a matching policy, an applicable plan and a verified source. Unconfirmed requirements are identified explicitly.

Current data coverage

Official CMS administrative facts, HCPCS-II list references and NCD metadata are available. Clinical code-to-rule decisions are not included. CMS coverage is not an authorization decision.

Review data coverage and methodology

Official payer resources

All references