Tennessee Department Of Finance And Administration — Division Of TennCare Prior Authorization Lookup
Latest Tennessee Department Of Finance And Administration — Division Of TennCare prior authorization updates2
- Prior AuthClinical/Medical PolicyEff. 2025-10-28Erectile Dysfunction (ED) MedicationsThis policy governs TennCare coverage and prior-authorization handling for medications, compounds, and devices used to treat erectile dysfunction or sexual dysfunction. ED agents are generally excluded, but sildenafil citrate and tadalafil may be covered for a medically necessary, FDA-approved non-ED indication such as pulmonary arterial hypertension when applicable requirements are met.All Tennessee Department of Finance and Administration — Division of TennCare updates
- Prior AuthClinical/Medical PolicyEff. 2023-09-01Opioid Criteria - Acute, Chronic, and ExceptionsThis policy governs TennCare coverage, quantity limits, and prior authorization requirements for acute, chronic, and extended opioid use. It applies to TennCare members and requires opioid prescriptions to be issued by a provider with a Tennessee Medicaid Provider ID.All Tennessee Department of Finance and Administration — Division of TennCare updates
Tool Description
Search Tennessee Department Of Finance And Administration — Division Of TennCareprior 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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