Eocco Prior Authorization Lookup
Latest Eocco prior authorization updates25
- Prior AuthClinical/Medical PolicyEff. 2026-07-09Surface Radiation Therapy for Treatment of Non-Melanoma Skin CancerDefines medical necessity, prior authorization documentation, coding, and exclusions for use of surface radiation therapy (SRT) to treat superficial non-melanoma skin cancers (BCC and cSCC) for the payer's covered population.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Botox® (onabotulinumtoxinA) coverageDefines prior authorization, dosing limits, and medical necessity criteria for onabotulinumtoxinA (Botox) across multiple indications for EOCCO members and providers requesting coverage.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Cinqair (reslizumab) (Intravenous) — Coverage CriteriaCriteria, dosing, coding, and prior authorization rules governing coverage of intravenous reslizumab (Cinqair) for members of the plan, including initial and renewal authorization requirements and concomitant therapy prohibitions.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Denosumab (multiple brands) — Prior Authorization and Coverage CriteriaDefines prior authorization, dosing limits, and medical necessity criteria for denosumab products (various brands/biosimilars) for EOCCO members; applies to providers requesting coverage/authorization for these agents.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Dysport (abobotulinumtoxinA) coverageThis policy governs prior authorization, dosing limits, and medical necessity criteria for Dysport (abobotulinumtoxinA) for multiple intramuscular, intradetrusor, and intradermal indications for members of the payer (EOCCO). It affects prescribers and facilities requesting coverage and prior authorization.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Fasenra (benralizumab) (Subcutaneous) prior authorization and coveragePolicy governing prior authorization, dosing limits, initial and renewal medical necessity criteria, and concomitant therapy restrictions for Fasenra (benralizumab) for Eocco members.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Genetic Testing — Coverage Criteria for Genetic & Molecular TestingPolicy governing medical necessity, coverage, and prior authorization requirements for genetic and molecular testing for eocco members, including prenatal, diagnostic, tumor marker assays, and pharmacogenetic tests.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Krystexxa (pegloticase) (Intravenous) — Prior Authorization and Coverage CriteriaDefines prior authorization, dosing limits, approval and renewal criteria, billing codes, and covered diagnoses for use of Krystexxa (pegloticase) for chronic gout in adults.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Myobloc (rimabotulinumtoxinB) — Coverage CriteriaDefines prior authorization, dosing limits, initial and renewal medical necessity criteria for Myobloc (rimabotulinumtoxinB) for multiple indications in adults; applies to providers requesting coverage through EOCCO.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Onpattro (patisiran lipid complex) (Intravenous) coverageThis policy defines prior authorization, dosing, renewal, and medical necessity criteria for intravenous Onpattro (patisiran lipid complex) for treatment of hereditary transthyretin-mediated (hATTR) amyloidosis with polyneuropathy for members covered by eocco.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Palonosetron: Aloxi®; Posfrea™ (Intravenous) — Coverage CriteriaDefines prior authorization, dosing limits, and medical necessity criteria for intravenous palonosetron products (Aloxi and Posfrea) for prevention of chemotherapy-induced nausea and vomiting (CINV) and post-operative nausea and vomiting (PONV). Applies to eocco payer benefit administration.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Radicava (edaravone) (Intravenous) — Coverage CriteriaDefines prior authorization, dosing limits, eligibility, renewal, and billing for intravenous edaravone (Radicava) for treatment of amyotrophic lateral sclerosis (ALS) for Eocco members.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Short-Acting Granulocyte Colony Stimulating Factors (SAG-CSF)Covers prior authorization, dosing, indications, and renewal criteria for short-acting G-CSF products (listed agents) for members receiving therapy or with conditions requiring neutrophil support; applies to eocco covered members and providers who prescribe these agents.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Spinal Cord Stimulators (Dorsal Column Stimulators)Medical necessity and coverage criteria for trial and permanent implantation of spinal cord stimulators, including neuropathic pain and refractory angina; prior authorization and documentation requirements for members and providers.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Temporomandibular Joint (TMJ) Non-Surgical TreatmentDefines coverage, clinical criteria, coding, and prior authorization documentation for non-surgical TMJ treatments for eocco members; applies to providers submitting claims for TMJ non‑surgical services under the referenced plans.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Virtual Colonoscopy (CT Colonography)Policy governing coverage and prior authorization requirements for CT colonography (virtual colonoscopy) for diagnostic and screening indications, affecting providers requesting imaging for eocco members.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-07-01Xeomin (incobotulinumtoxinA) coveragePolicy governing prior authorization, dosing limits, indications, and renewal criteria for Xeomin (incobotulinumtoxinA) for intramuscular, intradetrusor, intradermal, and intraglandular use for covered members.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-06-18Procedures and services considered always investigational or cosmeticList of specific procedures, services, and billing codes designated by Eocco/Moda Health Commercial as always investigational or cosmetic for Moda Health Commercial Group and Individual Members. Applies to coverage determinations and claims processing for the listed services.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-06-02Crysvita (burosumab-twza) (Subcutaneous) coverage criteriaDefines prior authorization, dosing, eligibility, monitoring, and renewal criteria for Crysvita (burosumab-twza) for X-linked hypophosphatemia (XLH) and tumor-induced osteomalacia (TIO) for members covered by eocco.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-06-02Ocrevus (ocrelizumab) (Intravenous) — Coverage CriteriaClinical prior authorization and medical necessity criteria for ocrelizumab (Ocrevus) intravenous administration for multiple sclerosis including dosing, renewal, and monitoring requirements for providers requesting coverage.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-06-02Ranibizumab (Byooviz, Cimerli, Lucentis, Nufymco) — Medical Necessity and Prior AuthorizationMedical necessity and prior authorization policy for intravitreal ranibizumab products (Lucentis and biosimilars Byooviz, Cimerli, Nufymco) for retinal conditions; applies to providers requesting coverage through Eocco.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-06-01Intervertebral Disc Prosthesis (Total Disc Arthroplasty)Medical necessity and coverage criteria for FDA‑approved cervical and lumbar intervertebral disc prostheses, including prior authorization documentation and coding, for Eocco members.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-06-01Low-level laser therapy (LLLT) (Photobiomodulation) for Prevention of Oral MucositisDefines medical necessity, coding, and prior authorization documentation for use of low-level laser therapy (photobiomodulation) to prevent oral mucositis in patients receiving cancer treatments that increase mucositis risk; applies to eocco members and their providers.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-06-01Magnetic Resonance–Guided Focused Ultrasound (MRgFUS) for Essential TremorMedical necessity and coverage criteria for magnetic resonance-guided focused ultrasound (MRgFUS) as a treatment for medication‑refractory essential tremor, applicable to eocco members and providers submitting prior authorization.All eocco updates
- Prior AuthClinical/Medical PolicyEff. 2026-06-01Thermography (Infrared Surface Temperature Imaging)This policy defines Eocco's coverage stance on thermography (infrared surface temperature imaging) and the circumstances under which thermography is considered experimental/investigational and not covered by the plan. It is directed to providers submitting requests for thermography services and prior authorization reviewers.All eocco updates
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Tool Description
Search Eoccoprior 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.
FAQ
Type a drug name (“Wegovy,” “Ozempic”), a procedure (“MRI,” “knee”), or a policy title into the search bar. Filter results by payer, specialty, policy type, or effective year. Open any result for the full policy page with clinical criteria, covered billing codes, documentation requirements, and effective dates.
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