Medicare Part B Prior Authorization and Step Therapy
Select Part B drugs require Prior Authorization before they can be administered. The approval or denial is based on the plan design and focuses on safety and proper medication use.
In addition, some Part B drugs will require Step Therapy, a form of utilization management that requires you to first try a preferred drug to treat a medical condition before we will cover another, non-preferred drug for that condition. Drugs that require step therapy are marked with an "ST" in the Medicare Part B Prior Authorization List below.
Part B Prior Authorization List (effective 01/01/2026)
Part B Step Therapy (effective 01/01/2026)
Submitting Authorization Requests
You may submit prior authorization requests via phone, fax, or mail. For fax and mail requests, please include a completed Prior Authorization Request (Part B) form.
Call: 1-800-932-7013
Monday – Friday 9 a.m. to 7 p.m. Eastern
Weekends 8 a.m. to 4:30 p.m. Eastern
Fax: 1-844-306-1163
Write:
CVS Caremark Medicare Part B Department
Attn: Part B NLX Team
P.O. Box 52000 MC 109
Phoenix, AZ 85072-2000
What you need to do
Beginning January 1, 2026, please submit all Part B drug prior authorization requests to CVS Caremark powered by NovoLogix using one of the methods described above.
If you have questions about these changes, please contact CVS Caremark at 1-800-932-7013.