UPDATE: Temporary Relaxation of Prior Authorization Requirements through June 2022 for Certain DME, Orthotic/Prosthetics, Enteral/Parenteral Nutrition and Medical Supplies

Date: 02/04/22

Please Note: This article has been updated. Please review the new article for details.

Superior HealthPlan is extending the temporary relaxation of prior authorization requirements for covered Durable Medical Equipment (DME), Prosthetics, Orthotics, Enteral/Parenteral Nutrition and Medical Supplies for Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) and CHIP members for prior authorization requested for service dates through June 2022.

The waiver of prior authorization requirements is only applicable for covered benefits for Medicaid  and CHIP children and Medicaid adults through June 2022. During this period, no changes have been made to the clinical criteria for the applicable service/categories that continue to require prior authorization.

Prior authorization for certain items and supplies are waived through June 2022 for Medicaid and CHIP members 0- 20 years of age only. Superior encourages providers to review the listing of items and supplies that do not require prior authorization during this time, before a supply or item is fabricated and/or dispensed.

Please review the listing of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) codes that DO NOT REQUIRE PRIOR AUTHORIZATION through June 2022: Prior Authorization CPT/HCPC Codes (PDF). 

For any questions on this notice, or to confirm if an item or supply requires prior authorization, please contact the Utilization Review department at 1-800-218-7508.

Please note: This article was originally posted on November 16, 2021, and has been updated to reflect current code list.