Meridian - Medicaid Authorization Lookup Tool Updates

October 2, 2019

Noted in the September Monthly Provider Notification, the Meridian Medicaid Authorization lookup tool for MI and IL has been updated.

As previously discussed, the following improvements have been made to the tool:

-          Additional Blanket Statements added

-          Both excel and PDF versions posted to our website

-          Accessibility on the website was updated to provide easy access to the tool. Providers now can access directly from the home page through the provider tool “Prior Auth Form and Requirements”.

-          Codes which are not on the applicable Medicaid Fee Schedules have been removed from the lookup tool. Previously, these codes reflected no PA required. A blanket statement was added at the top of the tool reflecting that these codes may not be payable.


Our ask is that Provider facing teams educate providers to utilize this tool for PA requirements in a partnered effort to give providers additional resources and reduce call volume.


Please note, in the monthly notification it was stated that Meridian will no longer status CPT/HCPC codes over the phone after November 18, however, this is not the case. PBEs will continue to status authorization requirements over the phone but will advise providers to utilize the lookup tool as their primary resource. The tool will continue to be updated regularly by Benefit Configuration to align with our internal CPT and remain a reliable resource for providers to use.