Medicare Part B prior authorization and step therapy drug 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.
is-hero
true
no-alt-text
true
hide-image-mobile
false
sticky-bar-enabled
false
show-sticky-text-mobile
false
lh-overlay
false
lh-theme
primary-extra-dark
lh-alignment
center
lh-content-width
md
lh-padding-top
xl
lh-padding-bottom
xl
lh-margin-top
none
lh-gutters
tight
search-input-name
cpt code search - medicare part b step
search-label
Search
add-focus-on-page-load
true
lh-theme
neutral-light
lh-spacing
default
lh-content-width
sm
lh-padding-top
md
lh-padding-bottom
xxs
lh-gutters
default
set-name
cpt code search - medicare part b step
collection-id
56608
front-end-id
56456
results-formatter
list
search-type
results-page
sort-order
ASC
always-sort
false
exact-match
true
cf-model
/conf/aem-global/settings/dam/cfm/models/cpt-codes
combination-logic
  • OR
tags
  • bcbsnc:cpt/procedure-type/step
  • bcbsnc:cpt/procedure-type/part-b
is-results-container
true
show-default-results
true
form-name
cpt code search - medicare part b step
analytics-search-type
cpt code search - carelon medicare
pagination-type
loadMore
results-per-page
4000
search-sets-formatter
table
sheet
/content/bcbsnc/us/en/site-configs/search-cf/search-cpt
table-sort-by
servicedescription
zebra
false
cell-padding
tight
divider
horizontal
error-message
No results found.
lh-theme
neutral-light
lh-content-width
xxl
lh-padding-top
xxs
lh-padding-bottom
md

General criteria for Medicare Part B Prior Authorization and Step Therapy Drugs

lh-id
container-c2b218a321
lh-context-id
container-c2b218a321
lh-theme
neutral-light
lh-spacing
default
lh-content-width
xl
lh-padding-top
md
lh-padding-bottom
sm
lh-gutters
default
is-grid
true
grid-gap
default
lh-id
container-c2b218a321
lh-theme
neutral-light
lh-spacing
default
lh-content-width
xl
lh-padding-top
md
lh-padding-bottom
xl
lh-gutters
default
layout
vertical-left
theme
white
media-type
none
icon-size
xxl
gradient
true
title
Medicare Part B Prior Authorization Criteria
heading-level
h3
heading-size
sm
title-alt
true
cta1-variant
outlined
cta1-text
View Criteria Details (PDF)
cta1-href
/content/dam/bcbsnc/pdf/providers/policies-guidelines-codes/medicare/um/medical-benefit-part-b/updates/medicare-part-b-prior-authorization.pdf
cta1-analytics-id
card-1-aafa2c3c7f-a77f0509e0-Medicare Part B Prior Authorization Criteria
is-grid-item
true
span
6
span-tablet
6
span-mobile
12
desktop-span
6
tablet-span
6
mobile-span
12
vertical-align
stretch
layout
vertical-left
theme
white
media-type
none
icon-size
xxl
gradient
true
title
Medicare Part B Step Therapy Criteria
heading-level
h3
heading-size
sm
title-alt
true
cta1-variant
outlined
cta1-text
View Step Therapy Details (PDF)
cta1-href
/content/dam/bcbsnc/pdf/providers/policies-guidelines-codes/medicare/um/medical-benefit-part-b/updates/partb-step-therapy-criteria.pdf
cta1-analytics-id
card-1-e50135320c-ea481114d9-Medicare Part B Step Therapy Criteria
is-grid-item
true
span
6
span-tablet
6
span-mobile
12
desktop-span
6
tablet-span
6
mobile-span
12
vertical-align
stretch
lh-id
footer-info
lh-context-id
footer-info
lh-theme
primary-extra-dark
lh-spacing
default
lh-content-width
xl
lh-gutters
default
lh-padding-top
none
lh-padding-bottom
none