Find out if prior authorization is required by entering the group number and procedure code.
Note: All non-emergent inpatient admissions require prior authorization.
This tool works for most BCBSAZ members. However, please refer to the exceptions below.
* Indicates required fields
Exceptions
Medications covered under pharmacy benefits: Visit pharmacy resources for BCBSAZ coverage and prior authorization requirements.
PCP Coordinated Care HMO plan members: See the prior authorization requirements PDF and download the Specialty Medication List.
Medicare Advantage members: See the MA prior authorization code list and request form in the HealthX secure provider portal.
TPA co-administered plan members: See the prior authorization requirements PDF or call the number on the back of the ID card.
CHS group members: Call the number on the back of the ID card or contact the group’s TPA.
FEP® members: See the prior authorization requirements PDF or visit the FEP health plan brochures page.
BlueCard® (out-of-area) members: Use the pre-service review tool in the BCBSAZ secure provider portal.
Disclaimers