New Pro Resource: Prior Authorization Requirements Tracker (2026)
How many times this week did someone on your team open a payer portal just to check whether something needs a prior authorization? We built something to fix that.
RevCycleAI Pro members now have access to the Prior Authorization Requirements Tracker — a searchable, filterable reference covering 50+ procedure categories across six major payers.
What's in the Tracker
- 50+ procedures across imaging, surgery, inpatient, therapy, home health, behavioral health, oncology, DME, and specialty drugs
- 6 payers: UHC/Optum, Aetna, BCBS (National), Cigna, Humana, Centene/WellCare
- PA status: Required, Conditional, MA-Only, or Not Required
- Notes on thresholds, step therapy rules, documentation traps, and plan-type variations
- Filter by payer or status, search by procedure name, CSV export
What We Learned Building It
Medicare Advantage is the outlier on almost everything. Procedures commercial plans don't require PA for often require PA under MA. The MA column tends to be the most surprising for teams that primarily work commercial.
Cigna has the most generous behavioral health stance. No PA for outpatient mental health visits. If you're getting denials on outpatient BH for Cigna, the issue isn't auth.
Biologic step therapy documentation is specific. "Patient tried and failed" is not enough — you need dates, dosing, and duration of failed agents documented in the record.
Access the Tracker in RevCycleAI Pro
Updated monthly. CSV export included. $19/month.
Open the Tracker →