Prior Auth Required

11133 - o Personal care screening tool (PCST) (Form F- ) completed per

This procedure appears on the selected insurer prior authorization source.

Check another codeExplore policy data
Prior authorizationPrior Auth Required
Procedure / Serviceo Personal care screening tool (PCST) (Form F- ) completed per
Procedure / Service Description

• All PA requests for personal care worker (PCW) services must include - • All PA requests for personal care worker (PCW) services must include: o Signed physician or ordering provider orders; o Personal care screening tool (PCST) (Form F-11133) completed per instructions; o Personal Care Addendum (Form F-11136) when applicable;

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.