← All states
AZ
WISeR pilot

Arizona Prior Authorization Requirements

Medicare AdvantageMedicare TraditionalDual-EligibleMedicaid FFS • AHCCCSPart DMedicaid MCO • AHCCCSCommercial (employer / fully-insured)Commercial — Marketplace QHP

PA required

58%

1,090 verified rules

Verified Jun 8, 2026

Service category PA

All programs combined
Durable Medical Equipment
5/6Conditional
Specialty Drugs
5/6Conditional
Skilled Nursing Facility
4/6Conditional
Outpatient Surgery
4/6Conditional
Home Health
4/6Conditional
Inpatient Hospital
4/6Conditional
Mental Health — Inpatient
4/6Conditional
Physical Therapy
3/6Conditional
Diagnostic Imaging
3/6Conditional
Substance Use Treatment
3/6Conditional
Occupational Therapy
3/6Conditional
Speech Therapy
3/6Conditional
Ambulance Transport
3/6Conditional
advanced_imaging
3/6Conditional
Laboratory
0/6No PA

Drug class PA

Part D federal protections flagged
Oral Oncology
14/16Conditional
ADHD Stimulants
14/16Conditional
growth_hormone
11/11Full PA
pulmonary_arterial_hypertension
11/11Full PA
migraine_cgrp
11/11Full PA
hereditary_angioedema
11/11Full PA
hepatitis_c_daa
11/11Full PA
antifungals_systemic
10/11Conditional
atypical_antipsychotics
10/11Conditional
testosterone_androgens
10/11Conditional
asthma_copd_biologics
10/10Full PA
il_inhibitors_biologics
10/10Full PA
ms_disease_modifying
10/10Full PA
anticonvulsants
9/11Conditional
glp1_agonists
9/9Full PA
tnf_inhibitors
9/9Full PA
pcsk9_inhibitors
9/10Conditional
jak_inhibitors
9/9Full PA
other_antidepressants
8/10Conditional
inhaled_respiratory
8/11Conditional
opioid_analgesics
8/10Conditional
Immunosuppressants
7/9Conditional
ppi_acid_reducers
7/11Conditional
antiplatelets
7/11Conditional
nsaids
7/10Conditional
Rare Disease / Orphan
6/7Conditional
oral_retinoids
6/10Conditional
anxiolytics_benzodiazepines
6/11Conditional
hemophilia_factors
6/6Full PA
Specialty Non-Biologic
5/6Conditional
Biosimilars
5/6Conditional
Hepatitis C
5/6Conditional
Brand (Generic Available)
5/6Conditional
Controlled — Schedule II
5/6Conditional
Antipsychotics
5/7Conditional
Diabetes — Non-Insulin
5/6Conditional
Specialty Biologics
5/6Conditional
Controlled — Schedule III–V
5/6Conditional
insulins
5/11Conditional
other_antidiabetics
5/10Conditional
opioid_use_disorder
5/11Conditional
wakefulness_agents
5/5Full PA
sedative_hypnotics
5/10Conditional
overactive_bladder
5/11Conditional
Diabetes — Insulin
5/6Conditional
Brand (No Generic)
5/6Conditional
HIV Antiretrovirals
4/16Conditional
statins
4/11Conditional
enzyme_replacement
4/4Full PA
immunoglobulins
4/4Full PA
skeletal_muscle_relaxants
4/9Conditional
dermatology_biologics
4/4Full PA
cystic_fibrosis_modulators
4/4Full PA
AntidepressantsFed. Protected
4/6Conditional
arbs
3/10Conditional
dpp4_inhibitors
3/9Conditional
triptans
3/11Conditional
calcium_channel_blockers
3/10Conditional
sglt2_inhibitors
3/9Conditional
anticoagulants_doac
3/10Conditional
oncology_supportive
3/3Full PA
antihistamines
3/9Conditional
vmat2_inhibitors
3/3Full PA
ssri_antidepressants
3/9Conditional
oxybate_salts
3/3Full PA
weight_loss_agents
3/4Conditional
bisphosphonates
3/11Conditional
antiparkinson_agents
3/3Full PA
dalfampridine
3/3Full PA
beta_blockers
2/10Conditional
ace_inhibitors
2/10Conditional
erectile_dysfunction
2/2Full PA
pulmonary_fibrosis_agents
2/2Full PA
diuretics
2/4Conditional
hepatitis_b_agents
2/2Full PA
other_cardiovascular
2/2Full PA
hematopoietic_growth_factors
2/2Full PA
GLP-1 (Weight Loss)
2/6Conditional
glp1_diabetes
1/1Full PA
gi_other
1/1Full PA
allergen_immunotherapy
1/1Full PA
vaccines
1/3Conditional
other_lipid_agents
1/1Full PA
cough_cold
1/1Full PA
antiparasitics
1/1Full PA
antibacterials_systemic
1/1Full PA
antigout_agents
1/2Conditional
cns_miscellaneous
1/1Full PA
bph_agents
1/3Conditional
topical_steroids
1/4Conditional
metabolic_bone_other
1/1Full PA
typical_antipsychotics
1/1Full PA
cmv_antivirals
1/1Full PA
dermatological_agents
1/1Full PA
adrenal_hormones
1/1Full PA
nmda_antagonists
1/1Full PA
prostaglandins_hormonal
1/1Full PA
ophthalmic_other
1/2Conditional
sleep_and_wakefulness_agents
1/1Full PA
thyroid_replacement
1/1Full PA
ophthalmic_antiallergy
1/1Full PA
sexual_dysfunction_agents
1/1Full PA
fibrates
1/1Full PA
ophthalmic_antibiotics
1/1Full PA
pituitary_suppressants
1/1Full PA
ophthalmic_glaucoma
1/2Conditional
thyroid_agents
1/3Conditional
leukotriene_modifiers
1/10Conditional
ophthalmic_antiinflammatory
1/1Full PA
serms
1/2Conditional
antivirals_other
1/2Conditional
aminosalicylates_ibd
1/1Full PA
electrolyte_mineral_replacement
1/1Full PA
electrolytes_vitamins
1/1Full PA
osteoporosis_anabolics
1/1Full PA
antiherpetic_agents
1/1Full PA
other_immunological
1/1Full PA
gi_bowel_motility
1/1Full PA
ophthalmic_anti_inflammatory_anti_infective
1/1Full PA
blood_formation_modifiers
1/1Full PA
immunological_immunomodulators
1/1Full PA
roflumilast
1/4Conditional
estrogens
1/1Full PA
eent_misc
1/1Full PA
laxatives
1/3Conditional
anthelmintics
1/3Conditional
fibromyalgia_agents
1/2Conditional
local_anesthetics
1/1Full PA
pediculicides_scabicides
1/1Full PA
tetracycline_antibiotics
1/1Full PA
pulmonary_fibrosis
1/1Full PA
antiandrogens
1/1Full PA
macrolide_antibiotics
1/1Full PA
phosphate_binders
1/2Conditional
esketamine
1/2Conditional
antiarrhythmics
1/3Conditional
other_cns
1/1Full PA
other_gi_agents
1/1Full PA
other_genitourinary
1/1Full PA
ophthalmic_dry_eye_misc
1/1Full PA
antiprotozoals
1/1Full PA
glucocorticoids
1/2Conditional
mineralocorticoid_antagonists
1/1Full PA
vitamins
1/3Conditional
respiratory_allergy_cough_cold
1/1Full PA
hemostasis_agents
1/1Full PA
mood_stabilizers
1/2Conditional
progestins
1/2Conditional
gi_protectants
1/1Full PA
misc_therapeutic_agents
1/1Full PA
continuous_glucose_monitors
1/1Full PA
gnrh_oncology_hormonal
1/1Full PA
infertility_agents
1/1Full PA
estrogens_hrt
1/1Full PA
ophthalmic_agents
1/1Full PA
miscellaneous_specialty
1/1Full PA
antibiotics_general
1/1Full PA
il1_other_immunomodulators
1/1Full PA
cannabidiol
1/2Conditional
parkinsons_agents
1/1Full PA
transplant_immunosuppressants
1/1Full PA
viscosupplements
1/1Full PA
myasthenia_gravis_agents
1/1Full PA
acromegaly_agents
1/1Full PA
als_agents
1/1Full PA
movement_disorders
1/1Full PA
hepatitis_b
1/1Full PA
oncology_hormonal
1/2Conditional
botulinum_toxins
1/1Full PA
hereditary_tyrosinemia
1/1Full PA
narcolepsy_cataplexy_agents
1/1Full PA
calcium_receptor_agonists
1/1Full PA
cortisol_synthesis_inhibitors
1/1Full PA
bleeding_disorders_agents
1/1Full PA
multiple_sclerosis_agents
1/1Full PA
carnitine_deficiency_agents
1/1Full PA
central_precocious_puberty
1/1Full PA
uterine_fibroids
1/1Full PA
endometriosis_agents
1/1Full PA
immunologic_misc
1/1Full PA
calcium_regulators_misc
1/1Full PA
urea_cycle_disorder
1/1Full PA
sickle_cell_disease
1/1Full PA
vasopressins
1/1Full PA
polyneuropathy_agents
1/1Full PA
immunomodulators
1/1Full PA
dermatology_antipsoriatics
1/1Full PA
alpha1_antitrypsin_deficiency
1/1Full PA
fertility_regulators
1/1Full PA
paroxysmal_nocturnal_hemoglobinuria
1/1Full PA
ophthalmic_anti_vegf
1/2Conditional
chelating_agents
1/1Full PA
growth_improvement_agents
1/1Full PA
platelet_disorders
1/1Full PA
autoimmune_physician_administered
1/1Full PA
cough_cold_allergy
1/1Full PA
hematopoietic_esa
1/1Full PA
dermatology_topical_other
1/1Full PA
metabolic_disorder_agents
1/1Full PA
calcimimetics
1/1Full PA
il_inhibitors_ibd
1/1Full PA
immunosuppressants_misc
1/1Full PA
neuro_psych_misc
1/1Full PA
ovulation_stimulants
1/1Full PA
ophthalmic_anti_inflammatory
1/1Full PA
pde4_inhibitors_inflammatory
1/1Full PA
antibiotics_misc
1/1Full PA
other_antibiotics
1/1Full PA
cholinesterase_inhibitors
1/1Full PA
diabetes_supplies
1/1Full PA
ibs_agents
1/1Full PA
ssri_snri_other_antidepressants
1/1Full PA
cardiovascular_agents
1/1Full PA
dermatology_topical_and_biologics
1/1Full PA
diabetes_supplies_glucose_monitoring
1/1Full PA
hormone_replacement_contraceptives
1/1Full PA
Compounded Medications
0/6No PA
alzheimers_agents
0/2No PA
contraceptives
0/3No PA
Opioid Treatment (MOUD)
0/6No PA
otic_agents
0/5No PA
dental_oral_agents
0/2No PA
oral_corticosteroids
0/1No PA
antimyasthenic_agents
0/1No PA
antimycobacterials_tb
0/1No PA
antidementia_alzheimers
0/1No PA
cannabinoid_antiemetics
0/3No PA
snri_antidepressants
0/2No PA
dental_products
0/1No PA
antithyroid_agents
0/1No PA
alcohol_use_disorder
0/1No PA
other_antivirals
0/1No PA
anxiolytics_other
0/1No PA
quinolone_antibiotics
0/1No PA
bipolar_agents_lithium
0/1No PA
alpha_agonists
0/1No PA
adrenal_suppressants
0/1No PA
alpha_blockers
0/2No PA
aminoglycoside_antibiotics
0/1No PA
ophthalmic_antivirals
0/1No PA
misc_analgesics
0/1No PA
cephalosporin_antibiotics
0/1No PA
penicillin_antibiotics
0/1No PA
anaphylaxis_epinephrine
0/1No PA
ergot_alkaloids
0/1No PA
opioid_reversal
0/1No PA
smoking_cessation
0/2No PA
anti_influenza
0/1No PA
parasympathomimetics
0/1No PA
sulfonamide_antibiotics
0/1No PA
inflammatory_bowel_disease
0/2No PA
antimycobacterials
0/1No PA
mast_cell_stabilizers
0/2No PA
vasodilators
0/1No PA
anticholinergics_parkinsons
0/1No PA
progesterone_modifiers
0/1No PA
gi_antispasmodics
0/2No PA
h2_antagonists
0/1No PA
antituberculars
0/1No PA
hepatitis_b_antivirals
0/1No PA
nutritional_dietary
0/1No PA
feminine_products
0/1No PA
antitubercular_agents
0/1No PA
antilipemics_fibrates
0/1No PA
aldosterone_antagonists
0/1No PA
digitalis_glycosides
0/1No PA
postherpetic_neuralgia
0/1No PA
antivirals_systemic
0/1No PA
tetracyclines
0/1No PA
gout_agents
0/2No PA
direct_renin_inhibitors
0/1No PA
migraine_ergotamines
0/1No PA
antibacterials_misc
0/1No PA
macrolides
0/1No PA
antilipemics_misc
0/1No PA
cardiovascular_misc
0/1No PA
non_opioid_analgesics
0/2No PA
fluoroquinolones
0/1No PA
antimalarials
0/2No PA
salicylates
0/1No PA
cephalosporins
0/1No PA
psychotherapeutic_misc
0/1No PA
musculoskeletal_therapy_agents
0/1No PA
nitrates
0/1No PA
antiparkinsonian_agents
0/1No PA
alcohol_deterrents
0/1No PA
anti_infectives_misc
0/1No PA
antidementia_agents
0/1No PA
diabetic_supplies
0/1No PA
antilipemics_bile_acid_resins
0/1No PA
potassium_removing_agents
0/1No PA
ulcer_therapy_combinations
0/1No PA
antilipemics_cholesterol_absorption
0/1No PA
gi_anticholinergics
0/1No PA
allergenic_extracts
0/1No PA
cns_misc
0/1No PA
smoking_deterrents
0/1No PA
endocrine_metabolic_misc
0/1No PA
dermatology_misc
0/1No PA
h2_receptor_antagonists
0/1No PA
prenatal_vitamins
0/1No PA
ophthalmic_anti_infectives
0/1No PA
antidiarrheals
0/1No PA
ophthalmic_antiglaucoma_combinations
0/1No PA
anaphylaxis_treatment_agents
0/1No PA
gastrointestinal_misc
0/1No PA
ophthalmic_prostaglandins
0/1No PA
dermatology_antibiotics
0/1No PA
menopausal_symptom_agents
0/1No PA
ophthalmic_anti_infective_anti_inflammatory
0/1No PA
respiratory_misc
0/1No PA
dermatology_local_anesthetics
0/1No PA
glucose_elevating_agents
0/1No PA
vaginal_anti_infectives
0/2No PA
cold_cough
0/1No PA
dermatology_rosacea
0/1No PA
ophthalmic_rho_kinase_inhibitors
0/1No PA
dermatology_antipruritic
0/1No PA
ophthalmic_carbonic_anhydrase_inhibitors
0/1No PA
ophthalmic_sympathomimetics
0/1No PA
ophthalmic_antiglaucoma_beta_blockers
0/1No PA
ophthalmic_misc
0/1No PA
genitourinary_misc
0/1No PA
electrolytes
0/1No PA
dmards
0/1No PA
nutritional_misc
0/1No PA
dermatology_antifungals
0/1No PA
rectal_corticosteroids
0/1No PA
ophthalmic_anti_inflammatories
0/1No PA
vitamin_d_analogs
0/1No PA
dermatology_scabicides_pediculicides
0/1No PA
benign_prostatic_hyperplasia
0/1No PA
dermatology_acne
0/1No PA
dermatology_actinic_keratosis
0/1No PA
mouth_throat_dental_agents
0/1No PA
ophthalmic_antiallergics
0/1No PA
xanthines
0/1No PA
dermatology_wound_care
0/1No PA
dermatology_antiseborrheics
0/1No PA
antimycobacterial
0/1No PA
cardiotonics
0/1No PA
digestive_enzymes
0/1No PA
estrogens_progestins
0/1No PA
arni_sacubitril
0/1No PA
vasopressin_desmopressin
0/1No PA
corticosteroids_systemic
0/1No PA
antipsoriatics_topical
0/1No PA
hematinics_other
0/1No PA
interstitial_cystitis
0/1No PA
hemostatics
0/1No PA
topical_anti_infectives
0/1No PA
nutritional_metabolic
0/1No PA
mouth_throat_dental
0/1No PA
vaccines_toxoids
0/1No PA
fibromyalgia_snri
0/1No PA
vitamins_minerals
0/1No PA
anorectal_rectal
0/1No PA
pharmaceutical_adjuvants
0/1No PA
smoking_alcohol_deterrents
0/1No PA
vasopressors_anaphylaxis
0/1No PA
medical_supplies_devices
0/1No PA
antianginal_nitrates
0/1No PA
antiemetics
0/1No PA
other_antihyperlipidemics
0/1No PA
opioid_reversal_antidotes
0/1No PA
anticoagulants_warfarin
0/1No PA
anticoagulants_heparins
0/1No PA
antidiarrheal_probiotic
0/1No PA
other_antihypertensives
0/1No PA
antimyasthenic_cholinergic
0/1No PA
methadone
0/1No PA

PA type breakdown

clinical_criteria
505
Conditional
80
Full PA
48

Federal protected classes requiring PA

ImmunosuppressantsPA required
Oral OncologyPA required
AntipsychoticsPA required
AntidepressantsPA required
AntidepressantsPA required
ImmunosuppressantsPA required
Oral OncologyPA required
AntipsychoticsPA required

State flags

Medicaid expansion state
WISeR pilot (high data quality)
FFS-dominant (minimal MCO)

Look up a specific PA rule for Arizona

Type a drug brand or service. Pick a program. Get the verdict, source URL, and confidence score in under 300ms.

Look up a AZ rule →← All states
Arizona Prior Authorization Requirements | Auth57 Labs