COVID-19 waiver of prior authorization for Med-Cal Fee-for-Service

The California Department of Health Care Services (DHCS) has temporarily suspended prior authorization requirements for Medi-Cal Fee-for-Service for all Medi-Cal covered benefit categories covered in the state plan that are currently subject to prior authorization.  Providers must still submit Treatment Authorization Requests (TAR) and Service Authorization Requests (SAR).  Providers should state “Patient impacted by COVID-19” on the TAR or SAR.  These TARs and SARs can be submitted after services have been provided, and will be expedited and approved as appropriate.  Providers must still submit supporting documentation to justify the need or medical necessity.

For TARs that have already been authorized that need an extension, providers can update the TAR with the statement “Patient impacted by COVID-19.”  (DHCS Letter, April 2, 2020.)