This webinar will review the new prior authorization (PA) demonstration for certain ambulatory surgical center (ASC) services furnished on or after December 15, 2025, in Florida, Maryland, Pennsylvania, and Texas. The service categories targeted by the demonstration are: Blepharoplasty, eyelid surgery, brow lift, and related services; Botulinum toxin injections, Panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy), and related services; Rhinoplasty and related services; and Vein ablation and related services.
Under PA, the provider submits the prior authorization request (PAR) and supportive medical documentation to the MAC and receives an affirmed or non-affirmed decision prior to rendering the service. This webinar will review the PAR process, review decision timeframes, potential results and documentation guidelines. Members of our PA team will be available for questions relating to the PA demonstration.