Molina Healthcare Prior Authorization

Molina Healthcare publishes service-specific prior authorization guidance. Start with the payer resource below, then confirm the member's plan and the requested service before care is scheduled or submitted.

At a glance

• Prior authorization is required for some services, and Molina directs providers to state-specific provider manuals and authorization pages for the applicable list of services, submission process, and documentation. Molina’s provider portal/Availity-based tools are used in some markets for authorization requests and status checks. Requirements vary by line of business and state.
• Prior authorization rules vary by state and line of business.
• Some markets use Availity Essentials as the secure provider portal; others reference Molina’s own provider portal or state-specific workflows.
• Do not assume a single universal authorization list or turnaround time across Molina plans.

Where to verify prior authorization requirements

• Verification resource 1
• Verification resource 2
• Verification resource 3

How to submit prior authorization requests

• Provider portal / Availity Essentials where enabled

• Fax / phone per state-specific authorization page or manual

• Mail / paper forms where applicable

• Submission resource 1

• Submission resource 2

Information commonly required

• Prior authorization request form or service request in the portal
• Supporting medical documentation for timely medical review
• Authorization number on the claim when required
• State-/product-specific procedure list or codification matrix
• Member and provider identifiers

Turnaround notes and caveats

• Molina states prior authorization/utilization management is available 24/7 in some markets.
• Exact turnaround times were not consistently stated in the official sources reviewed and may vary by state, service, and product.
• Prior authorization rules vary by state and line of business.
• Some markets use Availity Essentials as the secure provider portal; others reference Molina’s own provider portal or state-specific workflows.
• Do not assume a single universal authorization list or turnaround time across Molina plans.

Provider resources

• Molina Healthcare Provider Portal (login) (official)
• Molina Healthcare EDI Transactions / Provider Services Web Portal (official)
• Molina Healthcare Provider Home - South Carolina Medicaid (official)
• Molina Healthcare Provider Home - Idaho Medicaid (official)
• Molina Healthcare Provider Claims Submission - Virginia Medicaid (official)
• Molina Healthcare Provider Prior Authorization - Virginia Medicaid (official)
• Molina Healthcare Provider Manual - Ohio Medicaid 2026 (official)
• Molina Healthcare Corrected Claims Policy (official)

Sources