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Fidelis Care Authorization Grids Effective July 1, 2026
6/26/2026 • Posted by Provider Relations in Provider News

The following section of the Fidelis Care authorization grids has been updated effective July 1, 2026.

           

The following codes have been added to the Medicaid, CHP, Essential Plan, Ambetter Metal-Level Plans, and Medicare Authorization Grids and require prior authorization:

0636U   Babesia (Babesiosis), antibody detection of 20 recombinant protein groups, IgG

0637U   Babesia (Babesiosis), antibody detection of 20 recombinant protein groups, IgM

0638U  Bartonella (Bartonellosis), antibody detection of 32 recombinant protein groups, IgG

0639U   Bartonella (Bartonellosis), antibody detection of 32 recombinant protein groups, IgM

 

Visit:  Authorization Grids

 

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Fidelis Care Authorization Grids Effective July 1, 2026
6/26/2026 • Posted by Provider Relations

The following section of the Fidelis Care authorization grids has been updated effective July 1, 2026.

           

The following codes have been added to the Medicaid, CHP, Essential Plan, Ambetter Metal-Level Plans, and Medicare Authorization Grids and require prior authorization:

0636U   Babesia (Babesiosis), antibody detection of 20 recombinant protein groups, IgG

0637U   Babesia (Babesiosis), antibody detection of 20 recombinant protein groups, IgM

0638U  Bartonella (Bartonellosis), antibody detection of 32 recombinant protein groups, IgG

0639U   Bartonella (Bartonellosis), antibody detection of 32 recombinant protein groups, IgM

 

Visit:  Authorization Grids