Prior authorization requirements — California

On January 1, 2026, providers in California will have access to a prior authorization list (PAL) by line of business: Medicare, Medi-Cal and Commercial. The PAL will contain all HCPCS and CPT® codes/services that require prior authorization. If a code/service is not on the PAL, prior authorization is not required for in-network providers for that service. Prior authorization is required for all HCPCS and CPT® codes/services for out-of-network providers.

This new resource is designed to make your daily tasks more efficient and reduce unnecessary prior authorization submissions.

Download Medicare info  Download Medi-Cal info  Download Commercial info

These PALs do not apply to the Optum California client or owned medical groups and physician networks that do not leverage Curo as their medical management platform, which includes Optum, formerly Beaver Medical Group and Optum, formerly Pinnacle Medical Group.