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.
- View the list of new CPT PLA codes and CPT Category III codes (PDF)
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.
