Prior Auth Required

51215 - standard specified in 22 CCR § (except that the distinct part of a hospital does

This procedure appears on the selected insurer prior authorization source.

Prior authorizationPrior Auth Required
Procedure / Servicestandard specified in 22 CCR § (except that the distinct part of a hospital does
Procedure / Service Description

Skilled Nursing Facility by DHCS or is a distinct part or unit of a hospital, meets the - Skilled Nursing Facility: Any institution, place, building, or agency that is licensed as a Skilled Nursing Facility by DHCS or is a distinct part or unit of a hospital, meets the standard specified in 22 CCR § 51215 (except that the distinct part of a hospital does not need to be licensed as a Skilled Nursing Facility) and has been certified by DHCS for participation as a Skilled Nursing Facility in the Medi-Cal program. The term "Skilled

Likely documents
  • Confirm benefit details
  • Submit clinical notes if requested by the plan
Next actions
  • Confirm the current plan policy before submission.
  • Use the insurer authorization workflow for this listed code.