Payer policies
Kaiser Permanente clinical review criteria and authorizations
Kaiser Permanente publishes coverage criteria by region, not in one national library. Community providers find criteria and authorization rules on the provider site for the region they work with.
Kaiser Permanente Washington publishes its clinical review criteria publicly and says they are all reviewed every year. The Mid-Atlantic community provider portal publishes authorization policies, medical coverage policies and pre-certification lists.
Where Kaiser Permanente publishes its policies
Official Kaiser Permanente pages, checked Oct 25, 2026. Policies change often; always read the version on the payer's site for your date of service.
Clinical review criteria (Washington)
Kaiser Permanente Washington's clinical review criteria for community providers.
Prior authorizationAuthorizations (Mid-Atlantic community providers)
Authorization policies, medical coverage policies and pre-certification lists for the Mid-Atlantic region.
Kaiser Permanente in RCIntel
RCIntel's posted policy library does not include Kaiser Permanente policies yet. You can still work with any Kaiser Permanente policy today: upload the PDF to Payer Intelligence, and RCIntel parses it into sections and answers questions with page-level citations.
Ask a Kaiser Permanente policy a question
Upload a Kaiser Permanente policy to Payer Intelligence and ask it what you need to know. Every answer cites the section and page it came from.
Common questions
How often does Kaiser Permanente review its clinical criteria?
Kaiser Permanente Washington's criteria page says all of its clinical review criteria are reviewed annually.