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pluto-app.js

Prior Authorization 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.


Please note: Does not show benefits coverage — Refer to our Healthy Blue Provider Manual for coverage/limitations.

Click select to view code requirements

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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