Welcome to the Prior Authorization Portal information page.
The Prior Authorization Provider Portal will be introduced through a series of phased rollout waves across Pennsylvania, organized by review type, including provider type and specialty.
For each wave, providers included in that review type will first receive a kickoff communication with instructions on how to register for the portal. Providers will then complete the registration and onboarding process and attend an initial training session focused on how to use the portal for their specific review type.
Following training, providers may begin submitting prior authorization requests in the portal on their assigned start date. A follow-up training session will be held approximately two weeks later to address questions and issues that may arise during early portal use.
Additional review types, including those scheduled for future waves, will be added as implementation progresses. Once all planned rollout waves are complete, the portal will be open for use across all review and provider types, and any new providers will be directed to existing training materials aligned to their applicable review type.
Providers can Register and Onboard during their assigned Rollout Phase using the portal URL: https://pamedicaid.telligen.com
| Rollout Phase | Review Type | Provider Type (PT) Provider Specialty (PS) | Kickoff Communication | Portal Registration and Onboarding Begins | Training Dates |
|---|---|---|---|---|---|
| 1 | Private Duty Care | PT-05 / PS-050,051 PT-34 / PS-340 | 4/15/2026 | 4/16/2026 | Initial Training: 5/1/2026 Follow-up Training: 6/3/2026 |
| 2 | Medical Rehabilitation | PT-01 / PS-012,014 | 5/19/2026 | 5/20/2026 | Initial Training: 6/5/2026 Follow-up Training: 7/9/2026 |
| 3 | Home Health | PT-05 / PS-050 | 6/24/2026 | 6/25/2026 | Initial Training: 7/13/2026 Follow-up Training: 8/12/2026 |
| 4 | Durable Medical Equipment | PT-25 / PS-220,250,251,252 PT-01 / PS-220 PT-09 PT-10 / PS-100 PT-14 / PS-140 PT-20 / PS-220 PT-24 / PS-220, 240, 241, 242, 243, 245 PT-31 | 7/29/2026 | 7/30/2026 | Initial Training: 8/14/2026 Follow-up Training: 9/15/2026 |
| 5 | Dental | PT-27 | 9/1/2026 | 9/2/2026 | Initial Training: 9/17/2026 Follow-up Training: 10/19/2026 |
| 6 | Emergency OP Admission & PSR Outpatient | Emergency OP Admission: PT-01 / PS-010,021 PT-02 / PS-020 PSR Outpatient: PT-01 / PS-010,021 PT-02 / PS-020 PT-09 PT-10 / PS-100 PT-14 / PS-140 PT-27 PT-31 | 10/5/2026 | 10/6/2026 | Emergency OP Admission Initial Training: 10/21/2026 Emergency OP Admission Follow-up Training: 11/16/2026 PSR Outpatient Initial Training: 10/29/2026 PSR Outpatient Follow-up Training: 11/24/2026 |
| 7 | Outpatient Services & Medical Diagnostics | Outpatient Services: PT-01 / PS-183 PT-31 PT-08 / PS-082 PT-09 PT-10 / PS-100 PT-14 / PS-140 PT-15 / PS-150 PT-27 PT-33 Outpatient Services – Medical Diagnostics: PT-01 / PS-183 PT-28 / PS-280 PT-31 PT-09 PT-10 / PS-100 | 11/9/2026 | 11/10/2026 | Outpatient Services Initial Training: 11/25/2026 Outpatient Services Follow-up Training: 12/3/2026 Medical Diagnostics Initial Training: 12/21/2026 Medical Diagnostics Follow-up Training: 12/29/2026 |
| 8 | Emergency IP Admission & PSR Inpatient | Emergency IP Admission: PT-01 / PS-010 PSR Inpatient: PT-01 / PS-010 PT-09 PT-10 / PS-100 PT-14 / PS-140 PT-27 PT-31 | 12/14/2026 | 12/15/2026 | Emergency IP Admission Initial Training: 12/30/2026 Emergency IP Admission Follow-up Training: 1/25/2027 PSR Inpatient Initial Training: 1/7/2027 PSR Inpatient Follow-up Training: 2/2/2027 |
Rollout Phase | Review Type | Description |
|---|---|---|
1 | Private Duty Care | Private Duty Care is a covered benefit limited to beneficiaries under 21 years of age. Also referred to as shift care. This includes nursing care and pediatric home health aide services beyond an intermittent need in the home and community-based settings. |
2 | Medical Rehabilitation | Elective inpatient admissions to freestanding rehabilitation hospitals or medical rehabilitation units of general hospitals. Reviewed under the concurrent hospital review process. |
3 | Home Health | Includes skilled nursing, home health aides, physical, occupational, and speech therapies by enrolled home health agencies for care in the home for an intermittent, short-term need |
4 | Durable Medical Equipment | Includes durable medical equipment and appliances, medical supplies, supplemental nutrition, prosthetics and orthotics requiring prior authorization or program exception |
5 | Dental | Dental Services is a covered benefit to Pennsylvania Medicaid beneficiaries in the Fee-for-Service delivery system. Dental services is a covered benefit with limits, and services may require Prior Authorization, Program Exception or Benefit Limit Exception. |
6 | Emergency OP Admission & PSR Outpatient | Emergent, urgent, and elective outpatient admissions to short procedure units of general hospitals or freestanding ambulatory surgery centers. Reviewed under the automated utilization review or place of service review processes. |
7 | Outpatient Services & Medical Diagnostics | Includes the following outpatient services requiring prior authorization or program exception: advanced radiology imaging, proton therapy, biology-guided radiation therapy, hyperbaric oxygen treatment, medical diagnostics, and labs |
8 | Emergency IP Admission & PSR Inpatient | Emergent, urgent, and elective inpatient admissions to general hospitals. Reviewed under the automated utilization review or place of service review processes. |
Frequently Asked Questions (FAQ)
The Prior Authorization Provider Portal is a secure online system that allows providers to submit and manage prior authorization requests electronically. The portal is being implemented statewide through a phased rollout to ensure providers receive appropriate training and support.
The portal will be introduced through a series of phased rollout waves, organized by review type, which includes provider type and specialty. Each wave follows a structured approach that includes provider communications, registration, training, and support.
Providers will be notified directly via email when their applicable review type is scheduled for rollout. This communication will include instructions for portal registration, onboarding, and training. Providers should refer to the DHS Provider Portal landing page for the most current rollout information, as it serves as the single source of truth for dates and updates.
For each rollout wave:
- Providers receive a kickoff communication with registration instructions.
- Providers complete portal registration and onboarding.
- Providers attend an initial training session tailored to their review type.
- Providers begin submitting prior authorization requests through the portal.
- A follow‑up training session is held approximately two weeks later to address questions and early use issues.
The following is required for each prior authorization or program exception request:
- Record Identification Number or Social Security Number (alternatively, MA beneficiary’s first name, last name, and date of birth)
- Type of Request
- Place of Service
- Type of Service (program exception, general, etc.)
- Timing of the request (retrospective, prospective, concurrent)
- Service or admission start and end dates. A discharge date is only required for retrospective inpatient requests.
- Ordering/prescribing provider number or the provider first and last name and service location.
- Treating/service provider number or provider first and last name and service location.
- Diagnosis code(s)
- Procedure code(s) with modifiers, if necessary.
- Any clinical or supporting documentation to be uploaded to the request and pertinent for the review coordinator.
Not all provider types and specialties are included in the initial rollout waves. Additional review types will be added as implementation progresses. If your provider type or specialty is not yet listed, it may be scheduled for a future rollout wave. Providers should continue to monitor the DHS Provider Portal landing page for updates as new review types are introduced.
Once all planned rollout waves are completed, the Prior Authorization Provider Portal will be open for use across all review and provider types. New providers onboarding after statewide rollout will be directed to existing training materials aligned to their applicable review type.
Yes. Training is a required part of the rollout process and is designed to help providers understand how to use the portal for their specific review type. Training materials and sessions are structured to ensure providers are prepared before submitting prior authorization requests.
- Registration and onboarding questions:
pau_qtregistration@telligen.com - Portal navigation or functionality questions:
ra-pwqualitracsupport@pa.gov
By using the portal, you can:
Submit and manage
prior authorizations in real-time, reducing the need for paperwork, improving operational efficiency, and providing a more integrated approach to patient care.
Receive status updates,
email alerts, and messaging related to your prior authorization submissions, enhancing visibility for better tracking, smoother communication, and faster decision-making.
Respond to requests
for additional information directly through the portal, eliminating the need for lengthy email chains or phone calls, thereby reducing review times and accelerating the approval process.