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Precertification & Claims
Precertification Lookup
This tool:
is for outpatient services-inpatient services always require precertification
does not show benefits coverage–refer to our state-specific provider manuals for coverage/limitations
Please note: Drug description search is case sensitive. You must search using generic/chemical ingredient name and use lower case only.
Market
New York
Line of Business
Select Line Of Business
Medicaid/SCHIP/Family Care
Medicare-Medicaid Plan (MMP)
EP
Medicare FIDE
CPT/HCPCS Code or Code Description
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Click select to view code requirements
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No Procedure Found.
To refine your search, consider the following:
Enter a valid 5-digit code for best results
If you are searching by code description, limit your search to a single term for more matches
The code you are searching for may be invalid or expired. Such procedures are not available for authorization and will be denied.
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