Prior Authorization HCPCS Code Inquiry Tool

This is a self-service tool to allow ambulance service providers, hospital, or physician office staff responsible for submitting prior authorization requests (PARs), to determine if the procedure requested requires prior authorization.

Please note: Botox requests only require prior authorization (PA) when a drug code (J0585, J0586, J0587, J0588) is paired with a PA administration code (64612, 64615). Submissions that do not include paired codes or for administration sites other than 64612 or 64615 will result in rejection of PA request.

Reviewed 6/12/2024