Code Check Tool

  • Use Availity Code Check Tool for Commercial Plan Members

    Sign in to Availity to use the code check tool. You'll find it in the Premera Payer Space in Resources or through Authorization & Referrals > Additional Authorizations and Referrals. The code check tool only shows codes used for non-individual plan members (group, association, etc.) and doesn't provide member-specific information. Check our code list for required supporting documentation.

    The tool doesn't support the following Premera plans:

    • Individual
    • Federal Employee Program (FEP)
    • Some Shared Administration plans

    View prior authorization information for those plans. For pharmacy benefits, view drugs requiring approval.

    Note: We review all non-specific and unlisted codes for medical necessity, even if they don't specifically relate to a medical policy. The code check tool isn't a guarantee of coverage since member contracts may differ in benefits.

    Submit a prior authorization request

    Sign in to Availity to submit prior authorizations. View our prior authorization resources page for more information on submitting prior authorization requests for Individual, out-of-area, Federal Employee Program (FEP), and Medicare Advantage plan members.

    Note: Prior authorizations can't be submitted by phone.

    Learn more