Prior Authorization Exemption Status Inquiry Tool

Prior Authorization Exemption Status Inquiry Tool

This is a self-service tool to allow both hospital or physician office staff responsible for submitting PARs, to check the exempt status of the HOPD. This tool will only recognize the hospital 6-10 digit PTAN (CCN) number.

If the PTAN entered is not recognized, it is an indication that a PAR is required.

Please note: Physician, Ambulatory Surgical Center and Critical Access Hospital PTAN entries will not return results; however a PAR is not required for these facility types. Only hospital outpatient departments billing with a TOB code 13x require prior authorization.

Updates to this tool are completed annually. Please check back on or after December 10th each year for the most up-to-date OPD exemption status.

Revised 2/14/2025