News
Effective 10/1/26: Removal of Prior Authorization Requirement for Certain Procedures
Fecha: 01/09/26
Effective October 1, 2026, Superior HealthPlan will no longer require prior authorization for certain procedures for Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP and Ambetter Health members.
As a result, the following procedure code update is effective on October 1, 2026, according to the products listed below.
Ambetter Health:
Service Category | Procedure Code | Description |
Genetic Analysis | 86812 | HLA TYPING; A B/C SNGL ANTIG |
86813 | HLA TYPING; A B/C MX ANTIG | |
86817 | HLA TYPING; DR/DQ MX ANTIG | |
Home Services | S9211 | HOME MANAGEMENT OF GESTATIONAL HYPERTENSION |
S9213 | HOME MANAGEMENT OF PREECLAMPSIA | |
S9214 | HOME MANAGEMENT OF GESTATIONAL DIABETES | |
Transplant Services | 38208 | TPLNT PREP HEM PROGNATR CELL; THAW |
Medicaid and CHIP:
Service Category | Procedure Code | Description |
Behavioral Health | 90792 | PSYCH DIAG EVAL WITH MED SRVCS |
96121 | NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR | |
Sleep Medicine | 95805 | MULTIPLE SLEEP LATENCY TEST |
Durable Medical | E2607 | SKN PROTCTANDPSTN WC SEAT WDTH <22IN |
E2608 | SKN PROTCTANDPSTN WC SEAT WDTH 22IN/> | |
Hearing Services | L8624 | LIB CI/AO DVC SP EAR LEVEL REPL EA |
To review prior authorization requirements, please visit Superior’s Prior Authorization webpage.
For questions or additional information, contact Superior’s Prior Authorization department at 1-800-218-7508.