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POST
Add a facility-specific prior-auth override

Authorizations

X-API-Key
string
header
required

Path Parameters

ccn
string
required

6-digit CMS Certification Number (facility CCN / Medicare provider number).

Body

application/json

A facility-specific prior-auth rule that overrides shared payer rules.

pa_required
boolean
required

Whether PA is required under this facility's contract

auth_type
string | null

prior_auth, precert, notification_only, retrospective, exempt, or excluded_service.

Example:

"prior_auth"

code
string | null

CPT/HCPCS code the override targets

Example:

"72148"

code_type
string | null

CPT, HCPCS, or CDT

Maximum string length: 10
delegation_vendor
string | null

Delegated UM vendor, if any.

Maximum string length: 100
effective_date
string<date-time> | null
expiration_date
string<date-time> | null
payer_slug
string | null

Payer this override applies to. Omit to apply to all payers on the roster.

Example:

"fidelis-care"

reason
string | null

Why this override exists (carve-out, delegation, exclusion).

Maximum string length: 2000
service_category
string | null

Service category the override targets (used when no specific code).

Example:

"advanced_imaging"

source_document
string | null

Source grid/contract reference.

Maximum string length: 255

Response

The created override

A facility-scoped PA override.

id
string<uuid>
required
pa_required
boolean
required
auth_type
string | null
code
string | null
code_type
string | null
delegation_vendor
string | null
effective_date
string<date-time> | null
expiration_date
string<date-time> | null
is_active
boolean
default:true
payer_name
string | null
payer_slug
string | null
reason
string | null
service_category
string | null
source_document
string | null