Preauthorization and notification lists

The documents below list services and medications for which preauthorization may be required for patients with Medicaid, Medicare Advantage, dual Medicare-Medicaid and commercial coverage. Please review the detailed information at the top of the lists for exclusions and other important information before submitting a preauthorization request.

Summary of Preauthorization and Notification List Changes

Current lists

Previous lists

Jan. 1, 2020, Commercial Preauthorization and Notification List, PDF opens in new window

Jan. 1, 2020, Medicare and Dual Medicare-Medicaid Plans Preauthorization and Notification List, PDF opens in new window

Jan. 1, 2020, Part B Step Therapy Preferred Drug List, PDF opens in new window

Jan. 1, 2020, Kentucky Medicaid Preauthorization and Notification List, PDF opens in new window

Jan. 1, 2019, Commercial Preauthorization and Notification List , PDF opens in new window

Jan. 1, 2019, Medicare and Dual Medicare-Medicaid Plans Preauthorization and Notification List , PDF opens in new window

Jan. 1, 2019, Part B Step Therapy Preferred Drug List , PDF opens in new window

April 1, 2018, Florida Medicaid Preauthorization and Notification List , PDF opens in new window

Jan. 22, 2018, Commercial Preauthorization and Notification List , PDF opens in new window

Jan. 22, 2018, Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List , PDF opens in new window

July 20, 2017, Commercial Preauthorization and Notification List , PDF opens in new window

Jan. 23, 2017, Medicaid Preauthorization and Notification List , PDF opens in new window

Jan. 23, 2017, Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List , PDF opens in new window

Jan. 23, 2017, Commercial Preauthorization and Notification List , PDF opens in new window

Jan. 23, 2017, Medicaid Preauthorization and Notification List , PDF opens in new window

Jan. 18, 2016, Commercial Preauthorization and Notification List , PDF opens in new window

Jan. 18, 2016, Medicare Advantage and Medicare-Medicaid Plans Preauthorization and Notification List , PDF opens in new window

Jan. 18, 2016, Medicaid Preauthorization and Notification List , PDF opens in new window

Jan. 26, 2015, Commercial Preauthorization and Notification List , PDF opens in new window

Jan. 26, 2015, Medicare Advantage and Medicare-Medicaid Plans Preauthorization and Notification List , PDF opens in new window

Jan. 26, 2015, Medicaid Preauthorization and Notification List , PDF opens in new window

June 1, 2014, Commercial Preauthorization and Notification List , PDF opens in new window

March 1, 2014, Medicaid Preauthorization and Notification List (220 KB) , PDF opens in new window

Jan. 18, 2014, Commercial Preauthorization and Notification List , PDF opens in new window

Jan. 18, 2014, Medicare Advantage and Medicare-Medicaid Plans Preauthorization and Notification List , PDF opens in new window

Sept. 14, 2013, Commercial Preauthorization and Notification List , PDF opens in new window

Sept. 14, 2013, Medicare Advantage Preauthorization and Notification List , PDF opens in new window

Jan. 26, 2013, Medicare Preauthorization and Notification List , PDF opens in new window

Jan. 26, 2013, Commercial Preauthorization and Notification List , PDF opens in new window

Nov. 5, 2012, Commercial Preauthorization and Notification List , PDF opens in new window

Jan. 23, 2012, Medicare Advantage Preauthorization and Notification List , PDF opens in new window

Jan. 23, 2012, Commercial Preauthorization and Notification List , PDF opens in new window

Jan. 22, 2011, Medicare Advantage Preauthorization and Notification List , PDF opens in new window

Jan. 22, 2011, Commercial Preauthorization and Notification List , PDF opens in new window

Jan. 24, 2010, Medicare Advantage Preauthorization and Notification List , PDF opens in new window

Jan. 24, 2010, Commercial Preauthorization and Notification List , PDF opens in new window

July 10, 2009, Medicare Advantage Preauthorization and Notification List , PDF opens in new window

July 10, 2009, Commercial Preauthorization and Notification List , PDF opens in new window

Dec. 1, 2008, Medicare Advantage Preauthorization and Notification List , PDF opens in new window

Dec. 1, 2008, Commercial Preauthorization and Notification List , PDF opens in new window

Jan. 15, 2008, Preauthorization and Notification List, PDF opens in new window