Medicare D-SNP Prior Authorization Code Lookup

Find out if prior authorization from Highmark Health Options Duals (HMO SNP) is required for medical procedures and services. Enter a Current Procedural Terminology (CPT) code in the space below to get started. 

Prior authorizations are required for:
  • All inpatient admissions, including elective procedures.
  • Select outpatient and DME services.

The contents of this list are subject to change in accordance with plan policies and procedures and the Provider Manual. Providers should consult applicable medical policies for information regarding covered benefits. Recommendations contained in InterQual guidelines are not a guarantee of coverage. 

Have questions?

We can help. Review the Prior Authorizations section of the Medicare D-SNP Provider Manual. Call Provider Services at 1-833-841-8075, Monday–Friday, 8 a.m.–5 p.m. Or contact your Provider Account Liaison.