Medication prior authorization
Clinically administered prior authorization list
Quartz will make monthly updates to the prior authorization list. We encourage providers to review the prior authorization list regularly for any updates or changes we may make. Please contact Customer Success with specific code information to determine if an item or service requires prior authorization.
Medication prior authorization information
Prior authorization is required for the clinic-administered medications listed below:
- View the clinic administration medication list
- View the medical benefit PA criteria library
- View additional resources for medical benefit medications
- View Updates for future clinic administered medications
For patients that have pharmacy coverage through Quartz, prior authorization is required for the prescription medications listed in the prescription benefit PA criteria library.
Practitioners must submit a prior authorization request using one of the following ways:
- Online at My Quartz Tools
- Completed the clinically administered medication prior authorization request form