You must get prior authorization from the Fund for certain surgical procedures, prescriptions, equipment requests and hospital services. Refer to our Provider Quick Reference Sheets or choose any of the links below to see if you need to apply for prior authorization.

Questions? Email us at Providers@1199Funds.org or call our Provider Hotline at (646) 473-7160.

Services Requiring Prior Authorization

(PDF format)

• Ambulatory Surgical Procedures Requiring Prior Authorization
• Hospital Services
• Chiropractic Services
• Home Care, Certain Outpatient, DME and RX
• Medications Requiring Prior Authorization
• Radiology CPT Codes that Require a Prior Approval

To request prior authorization for one of these services, use the forms available here.