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Outpatient Department (OPD) Prior Authorization Calculator

A provisional affirmation prior authorization (PA) decision is a preliminary finding that a future claim submitted to Medicare for the service(s) likely meets Medicare's coverage, coding and payment requirements. The provisional affirmation PA decision is valid for 120 days from the date of the decision.

The Outpatient Department Prior Authorization Calculator will provide the end of the 120 day timeframe, in which the approved procedure should be performed before the authorization expires.

To determine the date the authorization expires, key the date of the Prior Authorization Affirmation and click Calculate.

Enter the date of the PA Decision:

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