Freedom Health policy

Standard Local Prior Authorization Code List

Standard Local Prior Authorization Code List is a public Freedom Health policy. It lists 3,068 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

View the original policy (PDF) ↗

Payer
Freedom Health
Line of business
Commercial
States
GA
Source
www.anthem.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes.

CodeOther Freedom Health policies
00002Policies naming 00002
00003Policies naming 00003
00004Policies naming 00004
00005Policies naming 00005
00006Policies naming 00006
00007Policies naming 00007
00008Policies naming 00008
00009Policies naming 00009
00010Policies naming 00010
00011Policies naming 00011
00012Policies naming 00012
00013Policies naming 00013
00015Policies naming 00015
00016Policies naming 00016
00019Policies naming 00019
0001UPolicies naming 0001U
00022Policies naming 00022
00023Policies naming 00023
00024Policies naming 00024
00025Policies naming 00025
00026Policies naming 00026
00027Policies naming 00027
00028Policies naming 00028
00029Policies naming 00029
0002MPolicies naming 0002M
00030Policies naming 00030
00031Policies naming 00031
00032Policies naming 00032
00033Policies naming 00033
00034Policies naming 00034
00035Policies naming 00035
00036Policies naming 00036
00037Policies naming 00037
00038Policies naming 00038
00039Policies naming 00039
0003MPolicies naming 0003M
00040Policies naming 00040
00041Policies naming 00041
00042Policies naming 00042
00043Policies naming 00043
00044Policies naming 00044
00045Policies naming 00045
00046Policies naming 00046
00047Policies naming 00047
00048Policies naming 00048
00049Policies naming 00049
00050Policies naming 00050
00052Policies naming 00052
00053Policies naming 00053
00055Policies naming 00055
00057Policies naming 00057
00059Policies naming 00059
0005UPolicies naming 0005U
00061Policies naming 00061
00062Policies naming 00062
00068Policies naming 00068
0006MPolicies naming 0006M
00071Policies naming 00071
00072Policies naming 00072
00073Policies naming 00073
00077Policies naming 00077
00079Policies naming 00079
0007MPolicies naming 0007M
0007UPolicies naming 0007U
00082Policies naming 00082
00084Policies naming 00084
00085Policies naming 00085
00090Policies naming 00090
00092Policies naming 00092
00095Policies naming 00095
00096Policies naming 00096
00097Policies naming 00097
00098Policies naming 00098
00100Policies naming 00100
00102Policies naming 00102
00103Policies naming 00103
00104Policies naming 00104
00105Policies naming 00105
00107Policies naming 00107
00110Policies naming 00110
00111Policies naming 00111
00112Policies naming 00112
00113Policies naming 00113
00114Policies naming 00114
00115Policies naming 00115
00116Policies naming 00116
0011MPolicies naming 0011M
00120Policies naming 00120
00121Policies naming 00121
00123Policies naming 00123
00124Policies naming 00124
00125Policies naming 00125
00126Policies naming 00126
00128Policies naming 00128
00129Policies naming 00129
0012MPolicies naming 0012M
00130Policies naming 00130
00131Policies naming 00131
00132Policies naming 00132
00133Policies naming 00133
00134Policies naming 00134
00135Policies naming 00135
00137Policies naming 00137
00139Policies naming 00139
0013MPolicies naming 0013M
00140Policies naming 00140
00141Policies naming 00141
00142Policies naming 00142
00143Policies naming 00143
00144Policies naming 00144
00145Policies naming 00145
00146Policies naming 00146
00147Policies naming 00147
00150Policies naming 00150
00152Policies naming 00152
00153Policies naming 00153
00154Policies naming 00154
00155Policies naming 00155
00156Policies naming 00156
00157Policies naming 00157
00158Policies naming 00158
00159Policies naming 00159
00160Policies naming 00160
00161Policies naming 00161
0016MPolicies naming 0016M
0016UPolicies naming 0016U
0017MPolicies naming 0017M
0017UPolicies naming 0017U
0018MPolicies naming 0018M
0018UPolicies naming 0018U
0019UPolicies naming 0019U
0022UPolicies naming 0022U
0023UPolicies naming 0023U
0026UPolicies naming 0026U
0027UPolicies naming 0027U
0029UPolicies naming 0029U
0030UPolicies naming 0030U
0031UPolicies naming 0031U
0032UPolicies naming 0032U
0033UPolicies naming 0033U
0034UPolicies naming 0034U
0036UPolicies naming 0036U
0037UPolicies naming 0037U
0040UPolicies naming 0040U
0045UPolicies naming 0045U
0046UPolicies naming 0046U
0047UPolicies naming 0047U
0048UPolicies naming 0048U
0049UPolicies naming 0049U
0050UPolicies naming 0050U
0052UPolicies naming 0052U
00534Policies naming 00534
0055UPolicies naming 0055U
00580Policies naming 00580
0062UPolicies naming 0062U
0069UPolicies naming 0069U
0070UPolicies naming 0070U
0071TPolicies naming 0071T
0071UPolicies naming 0071U
0072TPolicies naming 0072T
0072UPolicies naming 0072U
0073UPolicies naming 0073U
0074UPolicies naming 0074U
0075UPolicies naming 0075U
0076UPolicies naming 0076U
0078UPolicies naming 0078U
0079UPolicies naming 0079U
0080UPolicies naming 0080U
0087UPolicies naming 0087U
0088UPolicies naming 0088U
0089UPolicies naming 0089U
0090UPolicies naming 0090U
0091UPolicies naming 0091U
0092UPolicies naming 0092U
0094UPolicies naming 0094U
0095TPolicies naming 0095T
0098TPolicies naming 0098T
0100TPolicies naming 0100T
0101TPolicies naming 0101T
0101UPolicies naming 0101U
0102TPolicies naming 0102T
0102UPolicies naming 0102U
0103UPolicies naming 0103U
0105UPolicies naming 0105U
0106TPolicies naming 0106T
0107TPolicies naming 0107T
0108TPolicies naming 0108T
0109TPolicies naming 0109T
0110TPolicies naming 0110T
0111UPolicies naming 0111U
0112UPolicies naming 0112U
0113UPolicies naming 0113U
0117UPolicies naming 0117U
0118UPolicies naming 0118U
0120UPolicies naming 0120U
0129UPolicies naming 0129U
0130UPolicies naming 0130U
0131UPolicies naming 0131U
0132UPolicies naming 0132U
0133UPolicies naming 0133U
0134UPolicies naming 0134U
0135UPolicies naming 0135U
0136UPolicies naming 0136U
0137UPolicies naming 0137U
0138UPolicies naming 0138U
0152UPolicies naming 0152U
0153UPolicies naming 0153U
0154UPolicies naming 0154U
0155UPolicies naming 0155U
0156UPolicies naming 0156U
0157UPolicies naming 0157U
0158UPolicies naming 0158U
0159UPolicies naming 0159U
0160UPolicies naming 0160U
0161UPolicies naming 0161U
0162UPolicies naming 0162U
0164TPolicies naming 0164T
0164UPolicies naming 0164U
0165TPolicies naming 0165T
0166UPolicies naming 0166U
0169UPolicies naming 0169U
0170UPolicies naming 0170U
0171UPolicies naming 0171U
0172UPolicies naming 0172U
0173UPolicies naming 0173U
0174UPolicies naming 0174U
0175UPolicies naming 0175U
0176UPolicies naming 0176U
0177UPolicies naming 0177U
0179UPolicies naming 0179U
0200TPolicies naming 0200T
0201TPolicies naming 0201T
0202TPolicies naming 0202T
0203UPolicies naming 0203U
0204UPolicies naming 0204U
0205UPolicies naming 0205U
0206UPolicies naming 0206U
0207TPolicies naming 0207T
0207UPolicies naming 0207U
0209UPolicies naming 0209U
0211UPolicies naming 0211U
0212UPolicies naming 0212U
0213TPolicies naming 0213T
0213UPolicies naming 0213U
0214TPolicies naming 0214T
0214UPolicies naming 0214U
0215TPolicies naming 0215T
0215UPolicies naming 0215U
0216TPolicies naming 0216T
0216UPolicies naming 0216U
0217TPolicies naming 0217T
0217UPolicies naming 0217U
0218TPolicies naming 0218T
0218UPolicies naming 0218U
0219TPolicies naming 0219T
0220TPolicies naming 0220T
0221TPolicies naming 0221T
0228UPolicies naming 0228U
0229UPolicies naming 0229U
0230UPolicies naming 0230U
0231UPolicies naming 0231U
0232TPolicies naming 0232T
0232UPolicies naming 0232U
0233UPolicies naming 0233U
0234UPolicies naming 0234U
0235UPolicies naming 0235U
0236UPolicies naming 0236U
0237UPolicies naming 0237U
0238UPolicies naming 0238U
0239UPolicies naming 0239U
0242UPolicies naming 0242U
0243UPolicies naming 0243U
0244UPolicies naming 0244U
0245UPolicies naming 0245U
0247UPolicies naming 0247U
0248UPolicies naming 0248U
0249UPolicies naming 0249U
0250UPolicies naming 0250U
0253TPolicies naming 0253T
0253UPolicies naming 0253U
0254UPolicies naming 0254U
0255UPolicies naming 0255U
0258UPolicies naming 0258U
0260UPolicies naming 0260U
0262UPolicies naming 0262U
0264UPolicies naming 0264U
0265UPolicies naming 0265U
0266TPolicies naming 0266T
0266UPolicies naming 0266U
0267TPolicies naming 0267T
0267UPolicies naming 0267U
0268TPolicies naming 0268T
0268UPolicies naming 0268U
0269TPolicies naming 0269T
0269UPolicies naming 0269U
0270TPolicies naming 0270T
0270UPolicies naming 0270U
0271TPolicies naming 0271T
0271UPolicies naming 0271U
0272TPolicies naming 0272T

And 2,768 more in the original policy.

All Freedom Health policies

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.