Additional Changes to Prior Authorization Requirements: Podiatry and Durable Medical Equipment (DME)
|Date:||April 19, 2019|
|To:||Health Plan of San Joaquin (HPSJ) Providers|
|From:||HPSJ Medical Management Department|
|Subject:||Effective Immediately – Additional Changes to
Prior Authorization Requirements:
Podiatry and Durable Medical Equipment (DME)
Our HPSJ network providers are important partners in delivering care to our members. As we continue to seek ways to streamline processes, HPSJ has simplified prior authorization requirements for your busy office.
Effective immediately, prior authorization is no longer needed for the following:
- Walking Boot, Prefabricated(CPT L4360 and L4361)
- Ankle Foot Orthotic, Prefabricated (CPT L1906 and L1930)
- Surgical Boot (CPT L3260)
- Follow-up office visits to a local, in-network podiatrist
Prior Authorizations required:
- Tertiary (outside of San Joaquin and Stanislaus counties) and noncontracted podiatrists, will continue to require prior authorization for all services, including consultations, office visits, and routine x-rays.
Please direct any questions to our Customer Services Department at