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Prior Authorization Updates: Effective July 1, 2024

Wellcare prior authorization updates effective 7/1/2024 for new American Medical Association Current Procedural Terminology (CPT®) codes.

The new CPT Proprietary Laboratory Analyses (PLA) codes and CPT Category III codes (below) will require prior auth, unless determined to be a non-covered service, upon their effective date of 7/1/2024.

For other established codes, please use the Pre-Auth Check Tools on our websites to confirm if the code(s) requires prior authorization. Prior authorization requirements vary based on the line of business, so please select the applicable Pre-Auth Check Tool by the line of business.

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Y0020_WCM_134133E_M Last Updated On: 5/24/2024
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