Peach State Health Plan prior authorization, page 78

CPT code lookup

Each row is one code from the public prior authorization list. The description is the procedure or service name on that source row. This is not a coverage decision.

Prior authorization codes

Prior authorization codes
CodeDescriptionSource
J1786Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1805Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1806Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1809Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1811Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1812Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1813Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1814Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1823Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1826Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1830Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1833Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1836Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1920Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1921Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1930Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1931Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1932Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1941Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1943Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1944Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1950Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1951Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1952Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1954Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J1961Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2170Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2182Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2212Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2249Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2267Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2277Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2278Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2305Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2313Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2323Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2325Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2326Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2327Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2329Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2340Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2350Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2351Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2353Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2354Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2355Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2356Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2357Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2358Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy
J2359Medications (Injections, infusions and other forms)CMS Final Rule 0057-F Prior Authorization Requirements, Pg 14 Original policy

Sources

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.