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Blue Cross NC Home Providers Policies, guidelines and codes Services and CPT codes Medicare Part B prior authorization and step therapy drug codes Medicare Part B prior authorization and step therapy drug 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.
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General criteria for Medicare Part B Prior Authorization and Step Therapy Drugs
Medicare Part B Prior Authorization Criteria
View Criteria Details (PDF)
Medicare Part B Step Therapy Criteria
View Step Therapy Details (PDF)