To comply with the Centers for Medicare and Medicaid Services' Interoperability and Prior Authorization final rule, North Dakota Medicaid is required to post service authorization metrics annually. This includes a list of covered items and services (excluding drugs) that require a service authorization along with data related to service authorization approvals and denials for the previous calendar year. 

Items and services requiring a service authorization

North Dakota Medicaid requires a service authorization for certain procedures, services and items before being initiated, supplied or performed. Some services may need a service authorization to exceed limits as well. Service authorizations ensure members receive the care they need and that it's medically necessary. 

  • Applied behavioral analyses (autism services)
  • Dental 
  • Durable medical equipment, including supplies, prosthetics and orthotics
  • Hearing aids and related services
  • Home health
  • Hospice
  • Labs including genomic sequencing procedures, multianalyte assays, proprietary laboratory analyses, tier 1 and 2 molecular pathology
  • Photodynamic services
  • Physical medicine services, including physical and occupational therapy 
  • Private duty nursing
  • Surgical procedures related to:
    • Auditory system
    • Digestive system
    • Eye and ocular adnexa
    • Female genital system
    • Integumentary system
    • Male genital system
    • Musculoskeletal system
    • Nervous system
    • Respiratory system
    • Urinary system 
  • Vision services including eyeglasses, frames and lenses.

Refer to the Service Authorization Excel spreadsheet for a complete list of procedure codes that require a service authorization. 

Service authorization definitions

  • Standard (non-urgent) request - Prior authorization completed within seven calendar days.
  • Expedited (urgent) request - Prior authorization completed within 72 hours.
  • Request approved - The prior authorization request is approved.
  • Request denied - The prior authorization request is denied.
  • Retroactive service authorizations – Service authorizations submitted up to 90 days after the initial date of service.

Standard (non-urgent) service authorization requests

Requests submitted

  • 20,383

Requests approved

  • 15,023 or 73.70%

Requests denied

  • 5,360 or 26.30%

Requests partially denied

  • 0

Requests approved only after time for review was extended

  • 0

Expediated (urgent) service authorization requests

Requests submitted

  • 0

Requests approved

  • 0

Requests denied

  • 0

Requests partially denied

  • 0

Requests approved only after time for review was extended

  • 0

Time between receiving a service authorization request and sending a decision

Standard (non-urgent) prior authorization request 

Mean (average) days

  • 2.36 days

Median (middle) days 

  • 1.18 days 

Expediated (urgent) service authorization request (response due to provider within 72 hours)

Mean (average) days

  • 0

Median (middle) days