Provider Notices

Preauthorization (PA) requirements change: Medicaid Behavioral Health codes - Effective 5/20/19

4/15/2019 12:37:49 PM

Effective 5/20/2019, PacificSource will not be requiring a PA with the associated codes:G0176, G0177, H0004, H0005, H0006, , H0020, H0031, H0032, H0033, H0034, H0036, H0038, H0039, H0046, H2000, H2010, H2014, H2016, H2018, H2023, H2033, J1631, J2315, J2794, J3490, T1006, T1502, T1016, T1023, T2010, T2011.


Please call PacificSource with any questions regarding this notice.