For PBT, if we’ve already approved for administered treatment prior to Feb. 1, 2023, you do not need to submit a new prior authorization request for that approved treatment plan.
For IMRT, standard radiation therapy 2D/3D, IGRT, special services, Y90/SIRT or SBRT, including SRS services started between Dec. 1, 2022, and Jan. 31, 2023, you do not need to submit a prior authorization request. We’ll authorize the radiation therapy service(s) the member was receiving prior to Feb. 1, 2023, and the authorization will be effective for 90 days from the treatment start date. For any further radiation therapy services that extend after 90 days from the treatment start date, we will require prior authorization before the start of services.
The online tool will open on Jan. 25, 2023, for prior authorization requests with a start date of Feb.1, 2023.