Prior Auth Required

53210 - for non-covered services provided pursuant to 22 CCR section (d). Even in the

This procedure appears on the selected insurer prior authorization source.

Check another codeExplore policy data
Prior authorizationPrior Auth Required
Procedure / Servicefor non-covered services provided pursuant to 22 CCR section (d). Even in the
Procedure / Service Description

persons acting on behalf of a member for any Medi-Cal Covered Services except to - persons acting on behalf of a member for any Medi-Cal Covered Services except to collect third-party payment in accordance with 22 CCR section 53222(a), or payment for non-covered services provided pursuant to 22 CCR section 53210(d). Even in the event of CenCal Health’s failure to pay for Covered Services, providers, subcontractors, and downstream subcontractors are prohibited from billing or attempting to collect

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.