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Medicare Carelon Oncology CPT Codes

Medicare Carelon Oncology CPT Codes

Enter CPT and HCPCS codes in the search to determine if they require prior authorization. Codes that require prior authorization will have a link to direct you to related requirements and instructions. Codes are reviewed by Carelon if the drugs are being used for an oncology diagnosis.

You can view Carelon Medical Benefits Management clinical appropriateness guidelines on the Carelon website.

The PDF versions of the code lists have been removed. Please use the search tool to determine if the service requires prior authorization.

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