New Hampshire Department Of Health And Human Services Prior Authorization Lookup
- New Hampshire Department Of Health And Human Services coverage criteria
- All New Hampshire Department Of Health And Human Services policy updates
Latest New Hampshire Department Of Health And Human Services prior authorization updates16
- Prior AuthAdministrative/Operational PolicyCOVID-19 Emergency Administrative Protocols for New Hampshire MedicaidTemporary administrative, prior authorization, equipment, claims, and prescription-drug protocols for covered services provided to New Hampshire Medicaid members during the COVID-19 Public Health State of Emergency. Applies to Medicaid fee-for-service, participating managed care organizations, enrolled providers, and providers authorized through Executive Order #15.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicyDuchenne Muscular Dystrophy (DMD) Agents CriteriaPrior authorization and renewal coverage for eteplirsen, viltolarsen, golodirsen, and casimersen for Duchenne muscular dystrophy under the New Hampshire Medicaid Fee-for-Service Program.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicyElevidys (delandistrogene moxeparvovec-rokl) Coverage CriteriaThis policy governs prior authorization and coverage of Elevidys for New Hampshire Medicaid Fee-for-Service beneficiaries with Duchenne muscular dystrophy. Coverage requires all specified clinical, laboratory, treatment, and monitoring criteria.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicyEncelto (revakinagene taroretcel-lwey) CriteriaThis policy governs prior authorization for Encelto for adults with idiopathic macular telangiectasia type 2 (MacTel). Coverage requires detailed ocular-disease, treatment-safety, monitoring, and prior-treatment criteria.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicyHemophilia B Gene Therapy CriteriaThis policy governs prior authorization and coverage of Hemgenix (etranacogene dezaparvovec-drlb) for adult New Hampshire Medicaid fee-for-service members with qualifying congenital factor IX deficiency. It defines clinical eligibility, monitoring requirements, denial conditions, and the lifetime dose limitation.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicyHyaluronic Acid Derivatives - Injection CriteriaThis policy governs New Hampshire Medicaid Fee-for-Service coverage and prior authorization for hyaluronic acid derivative injections used to treat osteoarthritis symptoms. It applies to providers requesting initial approval or renewal for covered knee injections.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicyKebilidi (eladocagene exuparvovec-tneq) Coverage CriteriaThis policy governs prior authorization coverage for Kebilidi under the New Hampshire Medicaid Fee-for-Service Program for adult and pediatric patients with aromatic L-amino acid decarboxylase deficiency, subject to specified clinical and treatment criteria.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicyLenmeldy (atidarsagene autotemcel) Coverage CriteriaThis policy governs prior authorization and medical necessity requirements for Lenmeldy gene therapy under the New Hampshire Medicaid Fee-for-Service Program for children with specified presymptomatic or early symptomatic forms of metachromatic leukodystrophy.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicyRoctavian™ (valoctocogene roxaparvovec-rvox) CriteriaNew Hampshire Medicaid Fee-for-Service prior authorization and coverage criteria for a single lifetime dose of Roctavian in adults with severe congenital hemophilia A.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicySkysona (elivaldogene autotemcel) Coverage CriteriaThis policy governs prior authorization and coverage of Skysona (elivaldogene autotemcel) for New Hampshire Medicaid fee-for-service beneficiaries. It applies to boys aged 4 through 17 years with early, active cerebral adrenoleukodystrophy who meet specified clinical, laboratory, infection-screening, and treatment-planning requirements.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicySpinal Muscular Atrophy (SMA) CriteriaThis policy governs New Hampshire Medicaid Fee-for-Service prior authorization, quantity limits, approval durations, and renewal requirements for Evrysdi, Spinraza, Zolgensma, and Itvisma used to treat spinal muscular atrophy.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicySpravato (esketamine) Coverage CriteriaNew Hampshire Medicaid Fee-for-Service prior authorization, renewal, authorization duration, and quantity limits for Spravato nasal spray in adults with treatment-resistant depression or major depressive disorder with acute suicidal ideation or behavior.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicySpravato (esketamine) CriteriaThis policy governs New Hampshire Medicaid Fee-for-Service prior authorization, initial approval, renewal, quantity limits, and authorization durations for Spravato (esketamine) in adults with major depressive disorder, including treatment-resistant depression and major depressive disorder with acute suicidal ideation or behavior.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicySystemic Immunomodulator CriteriaNew Hampshire Medicaid Fee-for-Service prior authorization for systemic immunomodulators and their FDA-approved indications, including specialty-prescriber, indication, step-therapy, renewal, and denial requirements.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicyWaskyra (etuvetidigene autotemcel) Coverage CriteriaThis policy governs prior authorization and coverage of Waskyra for eligible pediatric patients and adults with Wiskott-Aldrich Syndrome under the New Hampshire Medicaid Fee-for-Service Program. Coverage requires all clinical, transplant eligibility, safety, monitoring, and treatment-use criteria to be satisfied.All New Hampshire Department of Health and Human Services updates
- Prior AuthClinical/Medical PolicyZynteglo (betibeglogene autotemcel) Coverage CriteriaNew Hampshire Medicaid Fee-for-Service coverage and prior authorization for Zynteglo in eligible adults and pediatric patients with transfusion-dependent beta thalassemia; coverage requires clinical, safety, treatment-preparation, and monitoring criteria and is limited to one treatment course.All New Hampshire Department of Health and Human Services updates
1–16 of 16
1 / 1
Tool Description
Search New Hampshire Department Of Health And Human Servicesprior 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.
Prior Authorization by Payer
Go deeper
Explore OpenPayer Data
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.
Toolbox
More OpenPayer Tools
- Billing Code LookupSearch CPT, HCPCS, J-codes, DRG, and dental codes by number or procedure name.
- Billing Code Reimbursement RatesBuild a reimbursement rate report across any mix of billing codes and states, comparing commercial payers against Medicare.
- Payer Comparison DashboardPick 2-5 payers to compare market share, premium, and membership by region, all at once.
- Facility Comparison DashboardPick 2-6 hospital facility types (or add a specific hospital) to compare facility count, revenue, net income, and Medicare/Medicaid payer mix by region, all at once.
- Healthcare Provider & Facility LookupFind hospitals and healthcare facilities by name, taxonomy, facility type, ownership, or state.
- Health Insurance Payer LookupSearch national health insurance payers and health plans by name and state presence.
- Provider Taxonomy Code LookupSearch NUCC taxonomy codes by code, specialty, grouping, or classification.
- CPT Modifier LookupSearch CPT modifiers by code or name — descriptions, when to use them, and payer policy context.
- Timely Filing LookupFind payer timely filing policies: claim deadlines, corrected claim windows, and appeal timeframes.
- Coverage Criteria LookupSearch payer coverage criteria and medical necessity requirements by drug, procedure, or payer.
- Payer Contact DirectoryClaims, prior authorization, provider services, and appeals contacts for health insurance payers.
Published by
Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.