CDPHP Prior Authorization

Coverage: CDPHP New York coverage; verify product, network participation and provider agreement.

Start with the reviewed CDPHP resources below. Confirm the member's current plan, the payer's operating status, and the requested service before scheduling care or submitting a request.

At a glance

• Check the current authorization guideline in the secure provider portal. The reviewed manual section is dated January 2025. Medicaid Select/HARP behavioral health and nonparticipating care can have separate requirements. Login is required for the complete service list.
• The reviewed manual section is dated January 2025. Medicaid Select/HARP behavioral health and nonparticipating care can have separate requirements. Login is required for the complete service list.

Where to verify prior authorization requirements

• Verification resource 1

How to submit prior authorization requests

• Not clearly published in the researched sources.

• No direct topic-specific link was captured in the current research set.

Information commonly required

• Not clearly published in the researched sources.

Turnaround notes and caveats

• The reviewed manual section is dated January 2025. Medicaid Select/HARP behavioral health and nonparticipating care can have separate requirements. Login is required for the complete service list.

Provider resources

• Official policy source (official)
• Official policy source (official)
• Official policy source (official)

Sources

Update notes

Last updated: 2026-10-30.

• Reviewed official authorization, claim submission and claim review manual sections. Kept the 180-day adjudication-based review period separate from initial filing.
• Claim submission PDF text extraction was unreliable; only official indexed submission text was usable. Initial filing and contract exceptions require provider confirmation.