All services a nonparticipating provider renders require precertification
Precertification Lookup 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.
CPT/HCPCS codes returned as requiring precertification in the Precert Look-up Tool are current and effective at the time of the search/inquiry. Any codes removed from Precert Look-up Tool since the last update do not require prior authorization. Codes requiring prior authorization may still require medical review prior to claims payment.
Please note: Benefits coverage not shown — refer to our state-specific provider manual for coverage/limitations.
Anthem Blue Cross and Blue Shield Medicaid is the trade name of Anthem Kentucky Managed Care Plan, Inc., independent licensee of the Blue Cross and Blue Shield Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.