Procedures Requiring Clinical Review for Prior Approval

Date Issued: 6/16/2016

We at EmblemHealth regularly review and update our prior approval policies as part of an ongoing effort to assure that our members receive medically necessary services at the appropriate level of care. Our latest review has resulted in new requirements. Beginning July 1, 2016, all prior approval requests for these CPT codes will require clinical review.

For more information, including a comprehensive list of procedures requiring prior approval, please refer to our Provider Manual at