Does Original Medicare Require Prior Authorization?
Whether Original Medicare requires prior authorization for a code.
Open the tool → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- HCPCS or CPT code
- 64483
- Setting
- Physician office or other non-facility setting
- State where the service is furnished
- TX
- Date of service
- 2026-05-04
Result: WISeR prior authorization required, or prepayment review: 64483 (epidural steroid injections for pain (LCDs L39015, L39240, L36920)) in TX.
The tool opens with these values already filled in. Replace them with your own.
What you enter
- HCPCS or CPT code
- Setting
- State where the service is furnished
- Date of service (YYYY-MM-DD)
How this is calculated
Citation
CMS Original Medicare prior authorization lists: hospital outpatient department; DMEPOS (42 CFR 414.234(c)(1), July 29, 2026); scheduled non-emergent ambulance; the ambulatory surgical center demonstration; and the WISeR operational guide, Appendix A (July 24, 2026). Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.