Prior Authorization

MDwise Medicaid prior authorization requirements are applicable to the following services:

  • Behavioral Health Services
  • Medical Services
  • Medications (‘Buy and Bill’ HCPCS Codes) billed under the medical benefit

Resources

Prior Authorization Lists

Behavioral Health Services

Medical Services

Medications (‘Buy and Bill’ HCPCS Codes) under the medical benefit

Contact Information for PA Submissions*

PA Inquiry Phone Numbers

MDwise Excel Hoosier Healthwise (HHW):  888-961-3100
MDwise Excel Healthy Indiana Plan (HIP):  888-961-3100

PA Fax Submissions

HHW: 888-465-5581
HIP Fax for Inpatient: 866-613-1631
HIP Fax for Outpatient: 866-613-1642

Email: padept@mdwise.org

Portal Login

*Please visit Pharmacy Resources | MDwise for contact information and PA requirements related to medications billed under the pharmacy benefit.