MDwise

MDwise Medicaid Prior Authorization Process

For pharmacy prior authorization forms, please visit our pharmacy forms page.

For more information, see our MDwise Prior Authorization Reference and Contact Guide.

UPDATE on MDwise Medicaid Prior Authorizations

Prior authorization requests for Indiana Health Coverage Programs: Hoosier Healthwise and Healthy Indiana Plan

Forms

• Portal Instructions - New!
• Universal PA Form for Hoosier Healthwise and HIP

• Prior Authorization Reference Guide for Hoosier Healthwise and Healthy Indiana Plan

• Behavioral Health Forms

Prior Authorization Lists

• 2020 Maternity Code Exemption List - NEW!
• Medical Prior Authorization and Exclusion Lists for Hoosier Healthwise and HIP Effective 10/1/21 - NEW! - Archived v. 3/1/21
• 2021 Searchable Behavioral Health Services that Require Prior Authorization for Hoosier Healthwise and HIP

For pharmacy prior authorization forms, please visit our pharmacy forms page.