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Johns Hopkins Health Plans

Authorization Changes Effective January 1 For EHP and Priority Partners

Effective Date: Jan. 1, 2027
Health Plans Affected: Employer Health Programs (EHP), Priority Partners 
Type of Change: Authorization Requirements Status

Explanation of Change:
Authorization status code changes have been confirmed for Johns Hopkins Health Plans and will go into effect starting January 1, 2027. These requirements affect members of all ages enrolled in Johns Hopkins Health Plans. 

Key: PA=Prior Authorization Required; NPA=No Prior Authorization Required; NC=Not Covered

EHP-Cigna Code Authorization Changes Effective 1-1-2027:

  • 20939 - Bone marrow aspiration for bone grafting, spine surgery only; NPA
  • 0211U - Oncology (pan-tumor), DNA and RNA by next-generation sequencing; PA

Priority Partners Unlisted Code Changes Effective 1-17-27

  • 80299 - Quantitative assay drug; NPA, subject to EviCore claims studio review

  • 81099 - Unlisted urinalysis PX, NPA; subject to EviCore claims studio review
  • 81599 - Unlisted MAAA; PA, per EviCore
  • 82664 - Electrophoretic test; NPA, subject to EviCore claims studio review

  • 84999 - Unlisted chemistry procedure; NPA, subject to EviCore claims studio review

  • 85999 - Unlisted hematology & coagj PX; NPA, subject to EviCore claims studio review

  • 86849 - Immunology procedure; NPA, subject to EviCore claims studio review

  • 86999 - Unlisted transfusion med PX; NPA, subject to EviCore claims studio review
  • 87999 - Unlisted microbiology PX; NPA, subject to EviCore claims studio review

  • 88199 - Unlisted cytopathology PX; NPA, subject to EviCore claims studio review

  • 88299 - Unlisted cytogenetic study; NPA, subject to EviCore claims studio review

  • 88399 - Unlisted surgical path PX; NPA, subject to EviCore claims studio review

  • 88749 - Unlisted in vivo lab service; NPA, subject to EviCore claims studio review

  • 89240 - Unlisted misc path test; NPA, subject to EviCore claims studio review

  • 93998 - Unlisted noninvasive vasc DX STD; PA
  • A9698 - Non-radioactive contrast imag matl noc; NPA

  • Q4100 - Skin substitute not otherwise specified; PA
  • Q5009 - Hospice/home health care in place NOS; PA

  • S2409 - Rep congn malform fetus-utero NOC; PA
  • S5497 - Home infus tx cath care NOC diem; PA
  • S9810 - Home therapy; NOC per hour; PA
  • V2199 - NOC single vision lens; PA


Prior Authorization for EHP and Priority Partners: Please use our secure online portal, Availity, to submit electronic prior authorization requests.