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UPDATE: Fidelis Care Authorization Grids Effective May 1, 2022
5/10/2022 • Posted by Provider Relations

The following sections of the Fidelis Care authorization grids have been updated effective May 1, 2022.


The Medicaid, Essential Plan, Medicare, & Metal Level Plan grids have been updated as follows:


Durable Medical Equipment/Supplies:

        Supplies requiring authorization:

         - Electric breast pumps (codes E0602 and E0603) have been removed and no longer require authorization.


Visit:  Authorization Grids


COVID-19 UPDATE: Please refer to this link:  Important Updates Regarding Coronavirus COVID-19, for authorization and coding guidelines related to the COVID-19 Pandemic.




Required Cultural Competency Training

Access the Provider Attestation Statement and submit completion of training.

Authorization Resources

To submit prior authorization request types, use the Fidelis Care provider portal.

Electronic Transactions

Submit claims electronically for faster processing and reimbursement.

Provider Access Online

Verify member eligibility or renewal status, check claims, send e-scripts, and more.

Utilization Management (UM)

Find information and links to external vendor authorization programs as well as links to internal Fidelis Care prior authorization resources.

Join Our Network

Apply to our provider network and become a part of the Fidelis Care mission.