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Medical codes for services that require precertification

June 28, 2017

As you know, we maintain a list of services that require preapproval/precertification from AmeriHealth prior to being performed for our members. For your reference, we have recently created a supplementary document to use with our precertification lists. This new document, Services Requiring Precertification, includes the CPT® and HCPCS codes, where applicable, that correlate with the services and injectable drugs on our precertification lists.

To access Services Requiring Precertification, visit our Medical Policy Portal and select Accept and Go to Medical Policy Online. Then select the Commercial tab from the top of the page. Then select New Jersey or Pennsylvania under Services Requiring Precertification from the left-hand menu.

Our precertification lists for AmeriHealth New Jersey and AmeriHealth Pennsylvania, which identify certain medical services and injectable drugs that require preapproval/precertification, will be updated to include links to the Services Requiring Precertification document.

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