Humana prior authorization, page 29
Requirements
Notification and authorization stay separate. An approved notification row keeps the notification label. The long descriptor is blank because no AMA-licensed CPT file was available to copy.
CPT code lookup
Prior authorization codes
| Code | Description | Source |
|---|---|---|
| 97037 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97039 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97110 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97112 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97113 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97116 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97124 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97129 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97130 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97139 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97140 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97150 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97164 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97168 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97530 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97533 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97535 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97537 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97542 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97545 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97546 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97550 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97551 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97552 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97750 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97755 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97760 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97761 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97763 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 97799 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| G0281 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| G0283 | Therapy (physical and occupational) | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 99199* | Transplant Evaluation – Notification | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 43 Original policy |
| 32850 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 32851 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 32852 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 32853 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 32854 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 33927 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 33928 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 33929 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 33935 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 33945 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 38205 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 38206 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 38230 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 38232 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 38240 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 38241 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
| 38243 | Transplant surgeries | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List, Pg 44 Original policy |
Medicare
The rows above are limited to the Medicare Advantage scopes in each table. They are not a single Medicare answer. Each row shows its own reviewed disposition.
Precertification list
Humana Medicare Advantage and D-SNP prior authorization and notification list