Services - Prior Authorization
Use the MPC Pre-Authorization tool to see if a prior authorization is needed. It’s quick and easy!
If an authorization is needed, you can submit online.
MPC Medicaid Pre-Authorization Tool
Enter the code of the service you would like to check:
Non-participating providers require prior authorization for all services except for emergent and self-referred services. For non-participating providers, learn how you can become an MPC provider.
Disclaimer: All attempts are made to provide the most current information on the Pre-Auth Needed Tool. However, this does NOT guarantee payment. Payment of claims is dependent on eligibility, covered benefits, provider contracts, correct coding, and billing practices. If you are uncertain that prior authorization is needed, please submit a request for an accurate response.
For specific details about authorization requirements, please refer to our Quick Reference Guide.
- Behavioral Health Services need to be verified by Optum Maryland
- Vision Services need to be verified by Superior Vision
- Dental Services need to be verified by DentaQuest
- Complex Imaging, MRA, MRI, PET, and CT Scans need to be verified by NIA
- Oncology Treatment Plans, including Simulation & Planning, to be verified by Eviti