Amerigroup. An Anthem Company.

Maryland Providers

Prior authorization requirements

To request or check the status of a prior authorization request or decision for a plan member, access our Interactive Care Reviewer (ICR) tool via Availity. Once logged in, select Patient Registration | Authorizations & Referrals, and then choose Authorizations or Auth/Referral Inquiry, as appropriate.

You may also use Availity’s Maternity Module to report a member’s pregnancy.

Don’t have an Availity account?

Register free now

Services billed with the following revenue codes always require prior authorization:

0240–0249 — All-inclusive ancillary psychiatric
0901, 0905–0907, 0913, 0917 — Behavioral health treatment services
0944–0945 — Other therapeutic services
0961 — Psychiatric professional fees

Pharmacy

Check our preferred drug list (PDL)

Services billed with the following revenue codes always require prior authorization:

0632 — Pharmacy multiple sources

Provider tools & resources

Interested in becoming a provider in our network?

We look forward to working with you to provide quality service for our members.