News and updates

Updates on Existing Criteria April 2021. The following changes to criteria are effective April 22, 2021: Preauthorization Criteria – Clinical Updates...

Effective May 17, 2021, PacificSource Health Plans will require prior authorization for the following nuclear medicine and SPECT/CT codes:...

Updates on Existing Criteria: March 2021. The following changes to criteria are effective March 22, 2021: Preauthorization Criteria – Clinical Updates Arcalyst...

Your commercial and Medicare patients may be asked to participate in the annual Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. The survey is overseen by a company called SPH...

Please note that providers may bill PacificSource for the administration of the vaccine, but not for the vaccine itself, which is paid for by the federal government. If you...

PacificSource is required to meet standards set by multiple federal and state regulators as well as accrediting standards and contractual obligations to various groups. As a contracted entity of...

Effective January 1, 2021, PacificSource will be removing inpatient notification requirements for maternity hospital stays for members on all commercial and Medicaid plans. If...

Updates on Existing Criteria: February 2021. The following changes to criteria are effective February 22, 2021: Preauthorization Criteria – Clinical Updates...

Effective January 1, 2021, PacificSource will allow testing codes G0480, G0481, G0482 and G0483 for members covered by our commercial plans. These...

Effective January 1, 2021, preauthorization will no longer be required for CPT codes 00811 – 00813 for members covered by our commercial plans. ...