Prior Authorization Portal

The Prior Authorization Portal is designed to make your job easier. It will streamline the process of submitting prior authorization requests, saving you time and effort. With faster approvals and fewer administrative burdens, you can focus more on patient care.

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 PhaseReview TypeProvider Type (PT)/Affiliation (PTA)
Provider Specialty (PS)
Kickoff CommunicationPortal Registration and Onboarding BeginsTraining Dates
1Private Duty CarePT-05 / PS-050,051
PT-34 / PS-340
4/15/20264/16/2026Initial Training: 5/1/2026
Follow-up Training: 6/3/2026
2Medical RehabilitationPT-01 / PS-012,0145/19/20265/20/2026Initial Training: 6/5/2026
Follow-up Training: 7/9/2026
3Home HealthPT-05 / PS-0506/24/20266/25/2026Initial Training: 7/13/2026
Follow-up Training: 8/12/2026
4Durable Medical EquipmentPT-25 / PS-220,250,251,252
PTA-01 / PS-220
PTA-09
PTA-10 / PS-100
PTA-14 / PS-140
PTA-20 / PS-220
PTA-24 / PS-220, 240, 241, 242, 243, 245
PTA-31
7/29/20267/30/2026Initial Training: 8/14/2026
Follow-up Training: 9/15/2026
5DentalPT-27 / PS-273,283 for Ortho9/1/20269/2/2026Initial Training: 9/17/2026
Follow-up Training: 10/19/2026
6Emergency OP Admission & PSR OutpatientEmergency OP Admission:
PT-01 / PS-010,021
PT-02 / PS-020

PSR Outpatient:
PT-01 / PS-010,021
PT-02 / PS-020
PTA-09
PTA-10 / PS-100
PTA-14 / PS-140
PTA-27
PTA-31
10/5/202610/6/2026Emergency 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
7Outpatient Services & Medical DiagnosticsOutpatient Services:
PT-01 / PS-183
PT-31
PTA-08 / PS-082
PTA-09
PTA-10 / PS-100
PTA-14 / PS-140
PTA-15 / PS-150
PTA-27
PTA-33

Outpatient Services – Medical Diagnostics:
PT-01 / PS-183
PT-28 / PS-280
PT-31
PTA-09
PTA-10 / PS-100
11/9/202611/10/2026Outpatient 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
8Emergency IP Admission & PSR InpatientEmergency IP Admission:
PT-01 / PS-010

PSR Inpatient:
PT-01 / PS-010
PTA-09
PTA-10 / PS-100
PTA-14 / PS-140
PTA-27
PTA-31
12/14/202612/15/2026Emergency 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

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:

  1. Providers receive a kickoff communication with registration instructions.
  2. Providers complete portal registration and onboarding.
  3. Providers attend an initial training session tailored to their review type.
  4. Providers begin submitting prior authorization requests through the portal.
  5. 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.

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.