Important Prior Authorization Updates

(Effective Oct. 15, 2025)

Thank you for being a participating provider with Meridian. As part of our ongoing work to improve the prior authorization (PA) process for both providers and members, we want to share some important updates to our PA requirements. This work is aligned with broader industry efforts, driven by commitments to regulatory agencies and America’s Health Insurance Plans (AHIP), to modernize and streamline prior authorization. Our goal is to reduce administrative burden, simplify submission and approval processes, and facilitate timely access to appropriate, high-quality care.

A full list of code changes for Meridian Medicaid can be found in this bulletin. These changes may include:

• Removing PA requirements based on criticality of review and clinical need.
• Creating a more uniform set of prior authorization requirements across our markets and lines of businesses, including adding and changing some PA requirements, to simplify processes, reduce confusion for providers, and support future efforts to expand real-time responses to requests.

Effective 1/1/2026, an additional subset of psychotherapy codes then those listed in this bulletin will require a PA after 24 visits in a calendar year. More information regarding these specific codes will be available on our website on or before 11/28/2025.

If you have questions about specific prior authorization codes or how these changes affect your practice, please complete the Provider Relations Inquiry Form to ensure a timely response to your request.