Prior Authorizations
Your Questions Answered
Community First Health Plans requires that certain services be authorized prior to being rendered.
Are You A Community First Member?
Learn more about referrals to specialists and prior authorization requests to help make the right choice for your family.
The following documents are a detailed description of the different authorization processes and request forms required for Community First Health Plans:
- Prior Authorization Process
- Prior Authorization Process – Private Duty Nursing
- 2021 Prior Authorization List Effective 01/01/2021
- 2021 Authorization List Codes – Government Programs
- 2022 Authorization List Codes – Government Programs
- 2023 Authorization List – Government Programs
- 2023 Authorization List Codes – Government Programs
Request Forms
- Texas Standard Prior Authorization Request Form for Health Care Services
- Home Health Services (Title XIX) DME/Medical Supplies Physician Order Form
See the full list of Prior Authorizations required for medical procedures/services by contracted and non-contracted providers below:
For a full list of Prior Authorizations compliant with Senate Bill 1742, please see the Prior Authorizations Compliant with SB1742 list.
Additional Resources
Annual Review Report
Plan Year:
Member Assistance
If you are a Member and have questions about prior authorization, please call Member Services at 1-800-434-2347, Monday through Friday, 8 a.m. to 5 p.m. We are happy to help.
PROVIDER ASSISTANCE
If you are a Provider and have questions about prior authorization, please refer to our Provider Quick Reference Guide which includes helpful prior authorization phone and fax numbers.