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