Removal of Prior Authorization Requirements for Outpatient Cardiac Rehabilitation Therapy
Date: 11/12/19
Effective November 1, 2019, Superior HealthPlan no longer requires prior authorization for outpatient cardiac rehabilitation therapy (CPT codes 93797, 93798 and HCPCS code S9472) for Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS) and CHIP members.
Effective January 1, 2020, cardiac rehabilitation services are limited to the following diagnoses:
As a reminder, providers can determine which specific codes require prior authorization by visiting Superior’s Pre-Auth Needed tool.
If you have any questions regarding this information, you may contact your dedicated Account Manager or Provider Services at 1-877-391-5921.