August 29, 2024
Changes are coming for sleep studies for Wellcare Medicare Advantage members.
As of October 1, sleep study authorizations for Medicare Advantage members should be submitted directly to the health plan. EviCore will no longer be managing Wellcare Medicare Advantage authorizations for sleep studies.
Prior Authorization requests for Sleep Study codes (95800, 95806, 95801, G0398, G0399, G0400) will not require a Prior Authorization. Facility-based codes (95807, 95808, 95810, 95811) will require a Prior Authorization.
Thank you for continuing to provide our Medicare Advantage members with high quality and compassionate care. If you have questions about any of this information, please contact Provider Services or e-mail ncproviderrelations@wellcare.com.
