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Frequently Asked Questions (FAQs) on the Prior Authorization Process for Certain Hospital Outpatient Department (OPD) Services

FAQs help to answer providers' questions on the OPD PA process

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: February 26, 2021

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.