CurrentArizona Complete HealthPolicy N/A

Wellcare CMS Final Rule 0057-F Prior Authorization Requirements: H0351 & H5590 (PDF)

This part lists procedure and service codes that require prior authorization as of 12/31/2025 for Arizona Complete Health (Wellcare CMS Final Rule 0057-F). It enumerates codes across multiple service categories (spinal surgeries, PT/OT/Speech therapy, plastic surgery, respiratory, audiology, injections/infusions, transportation, urology/kidney) and indicates the effective date for PA requirement.

Policy Summary

PayerArizona Complete Health

PolicyWellcare CMS Final Rule 0057-F Prior Authorization Requirements: H0351 & H5590 (PDF)

Policy CodePolicy N/A

Change TypeAdded procedure codes

Effective Date12/31/2025

Next Review Date

Key ActionProviders must obtain prior authorization for any procedure/service billed with the listed codes effective 12/31/2025; claims for these codes may be denied without prior authorization.

SourceLink

POLICY UPDATE CHANGES

Multiple procedure codes across specialties were added to the prior authorization-required list effective 12/31/2025.

200+Procedure codes added/listed

12/31/2025PA effective date

Policy summary

This document is Part 2 of 2 of the Wellcare CMS Final Rule 0057-F prior authorization requirements and enumerates the specific procedure and service codes that require prior authorization for Arizona Complete Health. The listed codes are effective 12/31/2025.