Healthy Blue, an Anthem Company Nebraska Providers

Nebraska Providers

Prior Authorization Requirements

To request or check the status of a prior authorization request or decision for a particular plan member, access our Interactive Care Reviewer (ICR) tool via Availity. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate.

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Behavioral Health

Fax all requests for services that require prior authorization to:





Prior authorization always required.

These behavioral health codes always require prior authorization:

0240–0249 All-inclusive ancillary psychiatric
0901, 0905–0907, 0913, 0917 Behavioral health treatment services
0944–0945 Other therapeutic services
0961 Psychiatric professional fees


Prior authorization always required.

These pharmacy codes always require prior authorization:

0632 Pharmacy multiple sources

Related Information

Provider Tools & Resources

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