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Expedited Prior Authorization (EPA) List

Washington Apple Health (Medicaid) Expedited Prior Authorization (EPA) List October 20, 2021 Every effort has been made to ensure this guide s accuracy. If an actual or apparent conflict between this document and an agency rule arises, the agency rules apply. Please see corresponding billing guides for the most current EPA criteria as this list may not be as up to date. Clinical Quality and Care Transformation, Authorization Services TABLE OF CONTENTS What is Expedited Prior Authorization (EPA).. 4 Access to Baby and Child Dentistry .. 5 Ambulance and ITA 6 Dental-Related Services .. 7 Enteral Nutrition .. 9 Habilitative Services .. 13 Hearing Hardware .. 14 Home Infusion Therapy/Parenteral Nutrition .. 15 Hospice 16 Inpatient Hospital Services .. 17 Medical inpatient WITHDRAWAL MANAGEMENT .. 17 Kidney Center Services .. 19 Maternity Support Services and Infant Case Management .. 20 Medical Equipment AND Supplies (MES).

Expedited prior authorization (EPA) is designed to eliminate the need for written authorization. The agency establishes authorization criteria, and identifies the criteria with specific codes, and/or situations, enabling providers to use an EPA number in ... EPA Guidelines. The provider must verify medical necessity for the EPA number submitted ...

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Blue Cross and BCN: Procedures that require prior ...

ereferrals.bcbsm.com

For information about finding clinical guidelines and submitting prior authorization requests, refer to these webpages on the ereferrals.bcbsm.com website: • Blue Cross AIM-Managed Procedures page • BCN AIM-Managed Procedures page Note: Medical oncology medications that r equire prior authorization by AIM are not included in this

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How to Obtain a Consumer’s Authorization before Gaining ...

marketplace.cms.gov

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