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Effective 10/1/26: Removal of Prior Authorization Requirement for Certain Procedures

Date: 09/01/26

Effective October 1, 2026, Superior HealthPlan will no longer require prior authorization for certain procedures for Medicaid (STAR, STAR Health, STAR Kids, STAR+PLUS), CHIP and Ambetter Health members.

As a result, the following procedure code update is effective on October 1, 2026, according to the products listed below.

Ambetter Health:

Service Category

Procedure Code

Description

Genetic Analysis

86812

HLA TYPING; A B/C SNGL ANTIG

86813

HLA TYPING; A B/C MX ANTIG

86817

HLA TYPING; DR/DQ MX ANTIG

Home Services

S9211

HOME MANAGEMENT OF GESTATIONAL HYPERTENSION

S9213

HOME MANAGEMENT OF PREECLAMPSIA

S9214

HOME MANAGEMENT OF GESTATIONAL DIABETES

Transplant Services

38208

TPLNT PREP HEM PROGNATR CELL; THAW

Medicaid and CHIP:

Service Category

Procedure Code

Description

Behavioral Health

90792

PSYCH DIAG EVAL WITH MED SRVCS

96121

NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR

Sleep Medicine

95805

MULTIPLE SLEEP LATENCY TEST

Durable Medical

E2607

SKN PROTCTANDPSTN WC SEAT WDTH <22IN

E2608

SKN PROTCTANDPSTN WC SEAT WDTH 22IN/>

Hearing Services

L8624

LIB CI/AO DVC SP EAR LEVEL REPL EA

To review prior authorization requirements, please visit Superior’s Prior Authorization webpage.

For questions or additional information, contact Superior’s Prior Authorization department at 1-800-218-7508.