Transcription of MEDICARE ADVANTAGE AUTHORIZATION REQUIREMENTS
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MEDICARE ADVANTAGE AUTHORIZATION REQUIREMENTS
MEDICARE ADVANTAGE AUTHORIZATION REQUIREMENTS For dates of service on or after October 1, 2023. These AUTHORIZATION REQUIREMENTS apply to all Cigna Healthcare MEDICARE ADVANTAGE markets. This document lists services, items and medications that AUTHORIZATION REQUIREMENTS require AUTHORIZATION prior to being provided or When required, it is the provider's responsibility to obtain administered to Cigna Healthcare MEDICARE ADVANTAGE AUTHORIZATION prior to services being rendered. Facilities are Plan customers. encouraged to verify that a prior AUTHORIZATION has been Any code included on this list requires AUTHORIZATION approved before providing a service or item, unless the regardless of how it is classified on this document. service is urgent or emergent care. Payment may be denied AUTHORIZATION is not required for emergency or for services rendered without AUTHORIZATION . urgent care. All final decisions concerning coverage and payment are Some services are managed by our external delegate, based on plan, customer eligibility, the customer's benefits, eviCore.
Durable Medical Equipment (continued) Prosthesis/Prosthetic Accessories Speech Device E2512 Home Health Laboratory (Includes Genetic Testing) G0151 G0152 G0153 G0155 G0156
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