Prior Authorization Lookup Tool

Find out if a service needs prior authorization. Type a Current Procedural Terminology (CPT) code or a Healthcare Common Procedure Coding System (HCPCS) code in the space below to get started.

Important notice

This tool provides general information for outpatient services performed by a participating provider. Prior authorization requirements also apply to secondary coverage.

The following services always require prior authorization:

  • Inpatient services.
  • Services from a non-participating provider.

The results of this tool are not a guarantee of coverage or authorization. All results are subject to change in accordance with plan policies and procedures and the Select Health of SC Health Care Professional and Provider Manual (PDF).

Find more information on submitting prior authorization requests.

If you have questions about this tool, a service or to request a prior authorization, contact Population Health Management at 1-888-559-1010.

Directions

  1. Enter a CPT/HCPCS code in the space below.
  2. Click “Submit”.
  3. The tool will tell you if that service needs prior authorization.
Providers