Prior authorization requirement changes effective October 1, 2021, for codes A0426 and A0428
PA requirements will be added for the following codes:
- A0426 — ambulance service, advanced life support, nonemergency transport, level 1 (ALS 1)
- A0428 — ambulance service, basic life support, nonemergency transport (BLS)
Not all PA requirements are listed here. Detailed PA requirements are available to contracted providers by accessing the provider self-service tool on the Availity* Portal at https://www.availity.com or on the provider website at https://www.empireblue.com/medicareprovider > Login. Contracted and noncontracted providers unable to access Availity can call the Provider Services number located on the back of their patient’s member ID card for PA requirements.
July 2021 Newsletter