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Provider Notices

Coverage Updates Effective January 1, 2021

10/30/2020 11:55:00 AM

Coverage Updates Effective January 1, 2021

We will be updating our prior authorization list effective for dates of service on or after January 1, 2021. Please review the summary of these changes below.

PA requirements will be removed on the following codes:

 

  • 00811

  • 00812

  • 00813

  • 61796

  • 61797

  • 61798

  • 61800

  • 70540

  • 70542

  • 70543

  • 70552

  • 70553

  • 70551

  • 95810

  • 95811

  • A6550

  • B4180

  • B4185

  • B4189

  • E2402

  • H2013

  • S9480

PA requirements will be added to the following codes:

  • 29806

  • 29807

  • 29827

  • 58660

  • 58661

  • H0018

  • Q4186

If you have questions regarding these changes, please contact your PacificSource Provider Services Representative.


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