Prior authorization codes
Community Health Choice, Inc. (CHC)
Active CPT codes that appear on the extracted prior authorization list for this health plan.
| Code | Procedure / Service | Effective | Revised | Confidence | Source |
|---|---|---|---|---|---|
| 02119 | by Texas Government Code §531 | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 12101 | compliance with the Americans with Disabilities Act of 1990 (42 U.S.C. § et seq) | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 13247 | P.O. Box | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 14534 | Pittsford, NY | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 66917 | Payer ID # | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 75247 | Dallas, TX | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 75356 | Dallas, TX | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 78711 | Austin, Texas -3247 | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 78714 | • Write to Maximus at the STAR program at: PO Box 149219, Austin, TX -9965 | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 78720 | Austin, TX -4077 | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 90839 | psychotherapy/crisis intervention visit (e.g., , ) on the same day | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 90840 | psychotherapy/crisis intervention visit (e.g., , ) on the same day | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96156 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96157 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96158 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96159 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96160 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96161 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96162 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96163 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96164 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96165 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96166 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96167 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96168 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96169 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96170 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 96171 | 1. Bill using CPT codes | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 99381 | ( , , , or ) | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 99382 | ( , , , or ) | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 99391 | ( , , , or ) | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 99392 | ( , , , or ) | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| 99429 | with U5 modifier and diagnosis code Z00.121 or Z00.129 | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| H0049 | 1. Bill using CPT codes (screening) and (brief intervention) | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| H0050 | 1. Bill using CPT codes (screening) and (brief intervention) | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| H1027 | Verification (Form ) submitted by clients. A copy is required during the appeal process | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |
| H3038 | Clients under the Medicaid eligibility threshold will receive a Form with their | 2021-01-01 | Not listed | 97% | [PDF] 2025 Provider Manual STAR Medicaid and CHIP - Providers |