Do you need to request a prior authorization (PA) for a prescription drug? Search for the right forms here.
- This page, Request a prior authorization for a drug, is offered by
- MassHealth
Request a prior authorization for a drug
Contacts
MassHealth Customer Service for Providers
Phone
Open Monday–Friday 8 a.m.–5 p.m.
MassHealth Drug Utilization Review Program
The Details of Request a prior authorization for a drug
How to request Request a prior authorization for a drug
- You can use our Prior Authorization Forms for Pharmacy Services page to find the right PA form.
- Search for the right form by either:
- Using the drug search engine at the top of the page.
- Selecting the first letter of the drug from the A to Z list up top.
- Scrolling though the list to find the right form.
- Search for the right form by either:
- You can also go directly to the MassHealth Drug List A - Z tool to search by drug name.
- You can also search for the right forms by using the Therapeutic Class Tables.
- Select the table class you need.
- Review the table and select the link to the PA form.
Contact for Request a prior authorization for a drug
Address
P.O. Box 278, Quincy, MA 02171
Phone
Open Monday–Friday 8 a.m.–5 p.m.
Fax
(617) 988-8974
Address
Fax
Fax:
(877) 208-7428