New PEHP preauthorization requirements
We want to keep you informed of new preauthorization (PA) requirements* on important medical procedures. Please familiarize yourself with these new PA requirements to provide the best care for your patients without unnecessary delays.
Effective October 1, 2023
Transplant surgeries related to the kidney, liver, pancreas, and heart. The affected CPT codes include: 50323, 50325, 50327, 50328, 50329, 50340, 50360, 50365, 50370, 50380, 47135, 47143, 47144, 47145, 47146, 47147, 33927, 33928, 33929, 33944, 33945, 81595, L8698, 33979, 33980, 33982, 33983, 48160, 48551, 48552, 48554, 48556, 50323, 50325, 50327, 50328, 50329, 50360, 50365, 50370, and S2065.
Effective January 1, 2024
Cardiac Ablation for the following CPT codes: 33250, 33251, 33254, 33256, 33257, 33259, 33261, 93613, 93650, 93653, 93654, 93655, 93656, 93657.
Cell Free Fetal DNA Testing for CPT code 81420.
You can view all PEHP clinical policies, authorization forms, and master policies via the New Portal. Here’s how:
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Log in to the New Portal and choose Office Management --> Communications Archive from menu on top.
- Next, choose a provider from your office.
- Then, choose the policy or authorization document from the Document Type drop-down menu.
- To obtain PA, please call PEHP at 801-366-7755.
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