Prior Authorization Requirements for Hyperbaric Oxygen and Supervision of Hyperbaric Oxygen Therapy
Effective October 1, 2019, prior authorization (PA) requirements will change for hyperbaric oxygen and supervision of hyperbaric oxygen therapy to be covered by Healthy Blue. Federal and state law, as well as state contract language and Centers for Medicare & Medicaid Services guidelines, including definitions and specific contract provisions/exclusions, take precedence over these PA rules and must be considered first when determining coverage. Noncompliance with new requirements may result in denied claims.
PA requirements will be added to the following:
- G0277 — Hyperbaric oxygen under pressure, full body chamber, per 30-minute interval
- 99183 — Physician attendance and supervision of hyperbaric oxygen therapy, per session
To request PA, you may use one of the following methods:
- Web: www.Availity.com *
- Fax: 800-823-5520
- Phone: 866-902-1689
Availity is an independent company that administers the secure provider portal on behalf of BlueChoice HealthPlan.
Not all PA requirements are listed here. Detailed PA requirements are available to contracted providers by accessing the Precertification Lookup Tool at www.Availity.com via www.HealthyBlueSC.com and select Providers. Contracted and noncontracted providers who are unable to access the Availity Portal can call Provider Services at 866-757-8286.
*This link leads to a third-party site. That organization is solely responsible for the contents and privacy policies on its site.