Prior Auth Required

51215 - 22, Section )

This procedure appears on the selected insurer prior authorization source.

Check another codeExplore policy data
Prior authorizationPrior Auth Required
Procedure / Service22, Section )
Procedure / Service Description

The criteria for receiving skilled-nursing services must meet the level-of-care standards set by Medi-Cal (Title - required for approval of admission to a long-term care facility of any kind. The criteria for receiving skilled-nursing services must meet the level-of-care standards set by Medi-Cal (Title 22, Section 51215). • The patient must require the continuous availability of procedures, including but not limited to: Administration of IV, IM or SC injections and IV or SC infusions.

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.