Maryland Physicians Care

Prior authorization

Locate authorization teams and submission faxes. Medical, pharmacy and delegated reviews can follow different routes.

prior authorization

Prior authorization / clinical review (phone prompts)

Official page read
Phone800-953-8854Published hours

Not published in this record

Product, plan and location

medicaid
Maryland

Mailing address

Not researched for this route

Menu guidance in the source record

Options 2 then 4 for Clinical Review

Menus can change. No live call verification is claimed.

Codes not found in the PA lookup tool: call Clinical Review. Scheduled inpatient/outpatient services and transplant PA requests fax 800-953-8856.

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

fax prior auth

Scheduled inpatient and outpatient services and transplant request fax

Official page read
Phone

No phone listed for this route

Fax

800-953-8856

Published hours

Not published in this record

Product, plan and location

medicaid
Maryland

Mailing address

Not researched for this route

Fax MPC Prior Authorization forms with clinicals for scheduled inpatient/outpatient services and transplants.

fax prior auth

Inpatient admission notification fax

Official page read
Phone

No phone listed for this route

Fax

800-385-4169

Published hours

Not published in this record

Product, plan and location

medicaid
Maryland

Mailing address

Not researched for this route

Inpatient admission notifications.

View source ↗ · Source checked 2026-10-25

Report an update

fax prior auth

Concurrent review / clinical information fax

Official page read
Phone

No phone listed for this route

Fax

855-905-5939

Published hours

Not published in this record

Product, plan and location

medicaid
Maryland

Mailing address

Not researched for this route

Concurrent review clinical updates for inpatient stays.

View source ↗ · Source checked 2026-10-25

Report an update

fax prior auth

Post-discharge services UM fax

Official page read
Phone

No phone listed for this route

Fax

855-905-5936

Published hours

Not published in this record

Product, plan and location

medicaid
Maryland

Mailing address

Not researched for this route

Post-discharge services utilization management requests.

View source ↗ · Source checked 2026-10-25

Report an update

prior authorization

Oncology medication pathways — Eviti for MPC

Official page read
Phone888-678-0990Fax

888-468-1423

Published hours

Not published in this record

Product, plan and location

medicaid
Maryland

Mailing address

Not researched for this route

Eviti handles oncology and radiation oncology regimen review; fax the Eviti checklist to 888-468-1423. Off-label oncology requests are processed by MPC.

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

prior authorization

Advanced imaging, cardiac and spine pain management PA — Evolent (RadMD) for MPC

Official page read
Phone800-424-4836Published hours

Not published in this record

Product, plan and location

medicaid
Maryland

Mailing address

Not researched for this route

High-tech radiology, outpatient cardiac procedures, and spine pain management authorizations via RadMD.com or Evolent call center.

Wait time: not establishedBest time from caller reports: not established. Published hours are not a wait forecast.

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Call preparation · editorial guide

Make the call count.

Locate authorization teams and submission faxes. Medical, pharmacy and delegated reviews can follow different routes.

Have ready in your secure workspace

  • Ordering and rendering provider details
  • Service codes, requested dates and units
  • Existing authorization or submission reference

Questions to resolve

  • Is this the correct reviewer for this service and product?
  • Which documents are missing, and where should they be sent?
  • What is the case number and next status-check date?

This is a general administrative checklist, not payer policy or advice about a particular patient. Confirm the current plan instructions.

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