Medicare Carelon CPT Codes
Carelon Medical Benefits Management uses CPT and HCPCS codes to guide appropriate use of services and align care with clinical guidelines, especially for Medicare Advantage plans.
Find Medicare Carelon CPT codes
Enter CPT and HCPCS codes in the search to determine if they require prior authorization. Codes that require prior authorization will have a link to direct you to related requirements and instructions.
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cpt code search - carelon medicare
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cpt code search - carelon medicare
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Don't see a search result?
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The code you searched is not on the Blue Medicare prior authorization list. This list is not all-inclusive, and prior authorization may still be required.
You can view Carelon Medical Benefits Management clinical appropriateness guidelines on the Carelon website. For more help, contact member services at the phone number on your member ID card.