Prior authorization codes

Tufts Health Plan

Active CPT codes that appear on the extracted prior authorization list for this health plan.

Search this plan

Check a specific CPT

CodeProcedure / ServiceEffectiveRevisedConfidenceSource
56112
38916032286091782<
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
95800
• / / / – Home To find a complete list of CPT
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
95801
• / / / – Home To find a complete list of CPT
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
95805
• – Multiple Sleep Latency Test
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
95806
devices • , will be always redirected and
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
95807
• / / – Attended through eviCore, please visit
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
95808
• / / – Attended through eviCore, please visit
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
95810
• / / – Attended through eviCore, please visit
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
95811
• – Attended Polysomnography with Sleep Management Program: Prior
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
A4604
• and – – PAP supply • eviCore recommends requesting the preferred
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
A7027
• and – – PAP supply • eviCore recommends requesting the preferred
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
A7046
• and – – PAP supply • eviCore recommends requesting the preferred
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
E0470
• / / – PAP Therapy preferred HST Code
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
E0471
• / / – PAP Therapy preferred HST Code
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
E0561
• – PAP Therapy humidifiers
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
E0601
• / / – PAP Therapy preferred HST Code
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
G0398
devices • , will be always redirected and
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
G0399
• / / / – Home To find a complete list of CPT
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore
G0400
• / / / – Home To find a complete list of CPT
2026-07-06Not listed97%
[PDF] Provider Orientation Sessions for Tufts Health Plan - eviCore