Effective September 1, 2025: Prior Authorization Update

Date: 06/01/25

Effective September 1, 2025, the following codes will no longer require prior authorization to be submitted to Ambetter Health.

• 81257 HBA1/HBA2 (alpha globin 1 and alpha globin 2) (eg, alpha thalassemia, Hb Bart hydrops fetalis syndrome, HbH disease), gene analysis; common deletions or variant (eg, Southeast Asian, Thai, Filipino, Mediterranean, alpha3.7, alpha4.2, alpha20.5, Constant Spring)

If you have questions, please contact Provider Services.