Presbyterian Health Plan

Prior authorization

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

fax prior auth

Physical health prior authorization — inpatient services fax

Official page read
Phone

No phone listed for this route

Fax

505-843-3107

Published hours

Not published in this record

Product, plan and location

commercial · medicare advantage · medicaid · exchange
New Mexico

Mailing address

Not researched for this route

Inpatient PA requests; phone requests via the Provider Care Unit 1-888-923-5757 option 4 then option 1. UM staff 8 a.m.-5 p.m. M-F; on-call UM nurse after hours. (Presbyterian Provider Prior Authorization Guide, 09.01.2026.)

View source ↗ · Source checked 2026-10-25

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fax prior auth

Physical health prior authorization — outpatient services fax

Official page read
Phone

No phone listed for this route

Fax

505-843-3047

Published hours

Not published in this record

Product, plan and location

commercial · medicare advantage · medicaid · exchange
New Mexico

Mailing address

Not researched for this route

Outpatient PA requests. (Presbyterian Provider Prior Authorization Guide, 09.01.2026.)

View source ↗ · Source checked 2026-10-25

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fax prior auth

Physical health prior authorization — long-term care fax

Official page read
Phone

No phone listed for this route

Fax

505-843-3195

Published hours

Not published in this record

Product, plan and location

medicaid
New Mexico

Mailing address

Not researched for this route

Long-term care PA requests (Turquoise Care LTSS). (Presbyterian Provider Prior Authorization Guide, 09.01.2026.)

View source ↗ · Source checked 2026-10-25

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fax prior auth

Physical health prior authorization — University of New Mexico requests fax

Official page read
Phone

No phone listed for this route

Fax

505-843-3108

Published hours

Not published in this record

Product, plan and location

commercial · medicare advantage · medicaid · exchange
New Mexico

Mailing address

Not researched for this route

PA requests for University of New Mexico services. (Presbyterian Provider Prior Authorization Guide, 09.01.2026.)

View source ↗ · Source checked 2026-10-25

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fax prior auth

Physical health prior authorization — home health care fax

Official page read
Phone

No phone listed for this route

Fax

505-559-1150

Published hours

Not published in this record

Product, plan and location

commercial · medicare advantage · medicaid · exchange
New Mexico

Mailing address

Not researched for this route

Home health care PA requests. (Presbyterian Provider Prior Authorization Guide, 09.01.2026.)

View source ↗ · Source checked 2026-10-25

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fax prior auth

Physical health prior authorization — transplant requests fax

Official page read
Phone

No phone listed for this route

Fax

505-843-3110

Published hours

Not published in this record

Product, plan and location

commercial · medicare advantage · medicaid · exchange
New Mexico

Mailing address
Presbyterian Health Services P.O. Box 27489 Albuquerque, NM 87125-7489

Health Services department (PA requests by mail)

Transplant requests. PA documents may also be mailed to Presbyterian Health Services. (Presbyterian Provider Prior Authorization Guide, 09.01.2026.)

prior authorization

Advanced imaging ordering — Stanson Health

Official page read
Phone888-487-0733Fax

646-502-5041

Published hours

Not published in this record

Product, plan and location

commercial · medicare advantage · medicaid · exchange
New Mexico

Mailing address

Not researched for this route

Advanced imaging (CT, CTA, MRI, MRA, PET, etc.) ordering support via the Stanson Health portal. (Presbyterian Provider Prior Authorization Guide, 09.01.2026.)

View source ↗ · Source checked 2026-10-25

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

prior authorization

Spine surgery prior authorization — Evolent Specialty Services

Official page read
Phone866-236-8717Fax

800-784-6864

Published hours

Not published in this record

Product, plan and location

commercial · medicare advantage · medicaid · exchange
New Mexico

Mailing address

Not researched for this route

Lumbar/cervical spine surgery PA via Evolent (RadMD). (Presbyterian Provider Prior Authorization Guide, 09.01.2026.)

View source ↗ · Source checked 2026-10-25

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

prior authorization

Oncology (office-administered chemotherapy) and radiation oncology PA — Evolent

Official page read
Phone866-500-7729Fax

213-596-3783

Published hours

Not published in this record

Product, plan and location

commercial · medicare advantage · medicaid · exchange
New Mexico

Mailing address

Not researched for this route

Menu guidance in the source record

Option 1 medical oncology; option 2 radiation oncology

Menus can change. No live call verification is claimed.

Evolent: option 1 medical oncology (fax (213) 596-3783), option 2 radiation oncology (fax (714) 494-8366). (Presbyterian Provider Prior Authorization Guide, 09.01.2026.)

View source ↗ · Source checked 2026-10-25

Report an update
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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