Prior Auth Required

99056 - Service(s) typically provided in the office, Non-covered Service Benefit Exception Considered non-covered unless

This procedure appears on the selected insurer prior authorization source.

Check another codeExplore policy data
Prior authorizationPrior Auth Required
Procedure / ServiceService(s) typically provided in the office, Non-covered Service Benefit Exception Considered non-covered unless
Procedure / Service Description

Code Description Plan Review Requirement Reviewed For Records Request - 99027 Hospital mandated on call service; out-of- Non-covered Service Benefit Exception Considered non-covered unless hospital, each hour member's contract indicates coverage. 99056 Service(s) typically provided in the office, Non-covered Service Benefit Exception Considered non-covered unless provided out of the office at request of member's contract indicates coverage. patient, in addition to basic service

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.