Prior Auth Required

97113 - 97533, 97535, 97537, 97542, 97545, 97546, 97750, 97755, 97760,

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service97533, 97535, 97537, 97542, 97545, 97546, 97750, 97755, 97760,
Procedure / Service Description

Out-of-Network Services Advance notification required.Plan members who use out-of- - Outpatient therapy 92507, 92508, 92526, 97012, 97016, 97018, 97022, 97024, 97026, (PT/OT/ST, chiropractic) 97028, 97032, 97033, 97034, 97035, 97036, 97039, 97110, 97112, 97113, 97116, 97124, 97139, 97140, 97150, 97164, 97168, 97530, 97533, 97535, 97537, 97542, 97545, 97546, 97750, 97755, 97760, 97761, 97799, G0129, G0283,*98940, *98941, *98942

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.