Prior Authorization Code Lookup

Find out if prior authorization from Highmark Health Options is required for medical procedures and services. Enter a Current Procedural Terminology (CPT) code in the space below to get started. 

Prior authorizations are required for:

• All non-par providers. Out-of-state providers. All inpatient admissions, including organ transplants.
• Elective surgeries.
• Any service that requires an authorization from a primary payer, except nonexhausted Original Medicare Services.
• Any exhausted or noncovered Original Medicare service.

The contents of this list are subject to change in accordance with plan policies and procedures and the Provider Manual. Providers should consult applicable medical policies for information regarding covered benefits. Recommendations contained in InterQual guidelines are not a guarantee of coverage.

Have questions?

We can help. Review the Prior Authorizations section of the current Provider Manual or call Provider Services at 1-833-957-0020, Monday–Friday, 8 a.m.–5 p.m. Or contact your Provider Account Liaison.