Beginning 12/1/24, prior authorization for the HCPCS codes and services listed in the table below do not require prior authorization for in-network providers:
|
Title
|
Codes
|
Change
|
Eff. Date
|
|
81511 Prior Authorization removal
|
81511: Fetal congenital abnormalities, biochemical assays of four analytes (AFP, uE3, hCG [any form], DIA) utilizing maternal serum, algorithm reported as a risk score (may include additional results from previous biochemical testing)
|
No prior authorization required
|
12/01/2024
|
Removal of the prior authorization and medical necessity review for these services is part of AmeriHealth Caritas Ohio's continued dedication to supporting providers in our shared commitment to high quality health care for our participants.
As a reminder, to verify whether a service requires prior authorization, use the Prior Authorization Lookup Tool on the provider website. Remember, you can save time by submitting your medical authorizations electronically via NaviNet.
Questions? Please contact your Provider Account Executive or call Provider Services at
1-833-644-6001.
