Prior Auth Required

01220 - (revised Dec.Sept. 1830, supersedes APL 220- )

This procedure appears on the selected insurer prior authorization source.

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Prior authorizationPrior Auth Required
Procedure / Service(revised Dec.Sept. 1830, supersedes APL 220- )
Procedure / Service Description

COVERAGERegarding Transitioning Medi-Cal Pharmacy Benefits from Managed Care to Medi-Cal Rx - 01-19, MEDI-CAL RX PHARMACY BENEFITS, AND CELL AND GENE THERAPY COVERAGERegarding Transitioning Medi-Cal Pharmacy Benefits from Managed Care to Medi-Cal Rx (revised Dec.Sept. 1830, 20252 supersedes APL 220-01220) VIII. DISTRIBUTION:

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.