If you're fully insured2, look up procedures, prescription medicines and behavioral health service that might require prior authorization.
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Prior Authorization
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Do You Need Prior Authorization?
Medical Procedures
Medical procedures like some surgeries, transplants, imaging and other tests often require prior authorization.
Medical or Prescription Drugs
Search medical drugs, like your prescriptions or specialty prescriptions, that may require prior authorization.
Behavioral Health Services
Prior authorization may be required for some behavioral services like psychological testing or psychiatric care.
Review BCBSTX's Prior Authorization Code Lists
To find the full list of services and drugs that require prior authorization, click below to download a copy of the spreadsheet. Except as otherwise noted, these prior authorization requirements are effective as of Jan. 1, 2025:
History
How BCBSTX Responds to Prior Authorization Requests
We keep track of how many prior authorization requests we receive, approve and deny each year. To review the statistics of prior authorization health data, click on the buttons below to search. For best results, use Google Chrome.

Medical History
Medical health history includes history data for surgeries, transplants, etc.
Medical Drug History
Medical drugs history includes history data for medicines or prescriptions.
Behavioral Health History
Behavioral health history includes data for mental health, psychiatry, etc.
Review BCBSTX's Prior Authorization Data
To find the full list of history for all prior authorization data, click below to download a copy. You can review data for the last 4 years or longer.
1Carelon Medical Benefits Management (Carelon) is an operating subsidiary of Anthem, Inc., an independent specialty medical benefits management company that provides utilization management services for BCBSTX.
eviCore® is a trademark of eviCore healthcare, LLC, formerly known as CareCore, an independent company that provides utilization review for select health care services on behalf of Blue Cross and Blue Shield of Texas.
2Not sure if you’re fully insured? Check with your HR department or benefits administrator. If you aren’t fully insured, check your benefit booklet to learn your list of services that require prior authorization. If you still have questions, please call the Customer Service number listed on your BCBSTX member ID card.