Amerigroup Prior Authorization Lookup
Latest Amerigroup prior authorization updates9
- Prior AuthReimbursement/Payment PolicyEff. 2019-04-01Harvoni (sofosbuvir/ledipasvir) coverageDefines prior authorization, approval durations, and clinical criteria for covering Harvoni (sofosbuvir/ledipasvir) for treatment of chronic hepatitis C in eligible members.All Amerigroup updates
- Prior AuthClinical/Medical PolicyEff. 2019-04-01Olysio (simeprevir) — Prior Authorization and Coverage CriteriaDefines Amerigroup pharmacy coverage, prior authorization, quantity limits, approval durations, and clinical criteria for use of Olysio (simeprevir) in treatment of chronic hepatitis C in adults.All Amerigroup updates
- Prior AuthClinical/Medical PolicyEff. 2019-04-01Ombitasvir + paritaprevir + ritonavir + dasabuvir (Viekira Pak / Viekira XR) — Coverage CriteriaCovers prior authorization and medical necessity criteria for use of ombitasvir/paritaprevir/ritonavir with dasabuvir (Viekira Pak, Viekira XR) for treatment of chronic hepatitis C genotype 1 in eligible members; applies to Amerigroup pharmacy benefits (not Medicare or plans without pharmacy benefits).All Amerigroup updates
- Prior AuthClinical/Medical PolicyEff. 2019-04-01Technivie (ombitasvir/paritaprevir/ritonavir) prior authorization and coverageThis document governs prior authorization, approval criteria, quantity limits, and approval duration for Technivie (ombitasvir/paritaprevir/ritonavir) for treatment of chronic hepatitis C virus (HCV) infection, including HCV/HIV-1 co-infection, for Amerigroup members (excludes plans without pharmacy benefits and Medicare).All Amerigroup updates
- Prior AuthClinical/Medical PolicyEff. 2019-04-01Vosevi (sofosbuvir/velpatasvir/voxilaprevir) coverageDefines prior authorization, approval durations, and medical necessity criteria for Vosevi (sofosbuvir/velpatasvir/voxilaprevir) for treatment of chronic hepatitis C in adults; applies to Amerigroup plans with pharmacy benefits (not Medicare).All Amerigroup updates
- Prior AuthClinical/Medical PolicyEff. 2019-04-01Zepatier (elbasvir/grazoprevir) — Coverage CriteriaDefines prior authorization, quantity limits, approval durations, and clinical criteria for coverage of Zepatier (elbasvir/grazoprevir) for members with hepatitis C; applies to Amerigroup pharmacy benefits (excludes Medicare and plans without pharmacy benefits).All Amerigroup updates
- Prior AuthClinical/Medical PolicyEpclusa (sofosbuvir/velpatasvir) prior authorization and coverageDefines Amerigroup prior authorization, approval durations, quantity limits, clinical criteria, and exclusions for Epclusa (sofosbuvir/velpatasvir) for treatment of chronic hepatitis C in adults.All Amerigroup updates
- Prior AuthReimbursement/Payment PolicyMavyret (glecaprevir/pibrentasvir) coverage and prior authorization criteriaDefines Amerigroup prior authorization, quantity limits, approval durations, clinical eligibility and exclusion criteria for Mavyret (glecaprevir/pibrentasvir) for treatment of chronic hepatitis C in covered members.All Amerigroup updates
- Prior AuthClinical/Medical PolicySovaldi (sofosbuvir) coverage criteriaDefines prior authorization, approval duration, quantity limits, and medical necessity criteria for Sovaldi (sofosbuvir) for treatment of chronic hepatitis C virus (HCV) infection for Amerigroup members.All Amerigroup updates
Tool Description
Search Amerigroupprior authorization policies by drug name, procedure, or policy title. Results include any policy that mentions prior authorization requirements (drug coverage criteria, imaging guidelines, site-of-service rules) not just documents titled “prior authorization.” Every result links to a full policy page with clinical criteria, covered billing codes, documentation requirements, and effective dates.
Filter by payer, specialty, policy type, or effective year; or search directly for a drug (“Wegovy,” “Ozempic”), a procedure (“MRI,” “knee arthroplasty”), or a policy number.
Coverage spans 110+ payers. Jump straight to the busiest prior-auth publishers: UnitedHealthcare, Cigna, Aetna, Anthem, and Centene. You can also browse the full policy updates feed.
Pair a prior-auth search with the billing code lookup to confirm the CPT or J-code on the claim, the payer lookup for plan footprint, and payer profiles for contacts and coverage context.
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Prior auth requirements change all the time. Keep up with every payer policy update in the live policy feed, or browse payers with prior authorization policies.
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