Before submitting your authorization request, please review the most recent list below for exclusions and other important information.
Prior Authorization Required Code List ( 2023 / 2024 )
NOTE: Effective September 1, 2023, CCHP has one link to view Prior Authorization for the Medicaid Side. The list(s) above can be utilized for code status searches prior to September 1, 2023. For the status of codes after September 1, 2023 the list below should be utilized. This list reflects all codes that require a PA as of September 1, 2023
View the Coverage and Limitation List
NOTE: The CCHP BadgerCare Plus No Prior Authorization Required List has been removed from our website. Please refer to the ForwardHealth Max Fee Schedule to determine if a code is covered for BCSP or the CCHP prior authorization list to determine if a code requires an authorization.
Submit Authorizations Online
Network providers should submit inpatient admission notifications and prior authorization requests online using the CareWebQI authorization tool.
Out-of-network providers must call CCHP's Clinical Services department at 877-227-1142 (option 2) for authorization requests. The CareWebQI authorization tool gives network providers the online capability to:
- Quickly submit an authorization request
- Receive a reference number, an approval or review notification immediately
- Provide concurrent review information for inpatient admissions
Questions?
For questions or assistance with your authorization request, call:
Chorus Community Health Plans - Clinical Services Department
Toll-free: 877-227-1142, option 2
Local: (414) 266-5707
Affirmative Statement
Chorus Community Health Plans (CCHP) wants its members to get the best possible care when they need it most. To ensure this, we use a auto authorization process, which is part of our Utilization Management (UM) program. UM decision-making is based only on appropriateness of care and service, and existence of coverage. CCHP does not specifically reward practitioners or other individuals for issuing denials of coverage. Financial incentives for UM decision makers do not encourage decisions that result in underutilization.