Prior Authorization, by Specialty
Prior authorization doesn't burden every specialty the same way. The drug classes, the step-therapy rules, the re-authorization cadences, and the cost all differ. These guides break down the prior-auth burden for each high-burden specialty — and what can be done about it.
- Oncology 96% of oncologists say prior authorization delays patient care Read the guide →
- Dermatology 12 days median from prescription to biologic approval (IQR 5.5–23) Read the guide →
- Endocrinology ~100% of Medicare GLP-1 prescriptions now require prior authorization Read the guide →
- Rheumatology 27% lower odds of treatment effectiveness under step therapy in psoriatic arthritis Read the guide →
- Gastroenterology ~30 days mean time to biologic approval in inflammatory bowel disease Read the guide →
- Ophthalmology 96% of anti-VEGF prior authorizations are approved — but most are delayed first Read the guide →
- Neurology 60–90 days to resolve an appealed CGRP monoclonal antibody or Botox denial Read the guide →
- Psychiatry ≥2 documented antidepressant failures required before TMS or Spravato Read the guide →
- Pulmonology ~13 hrs per physician each week spent on prior authorization Read the guide →
- Family Medicine 82% of appealed prior authorization denials overturned — most were never a real 'no' Read the guide →
- Allergy & Immunology 29% of physicians report prior authorization led to a serious adverse event Read the guide →
- Cardiology ~31% of patients prescribed PCSK9 inhibitors ever start the drug — prior auth rejects most on first submission, cost blocks the rest Read the guide →
- Internal Medicine 39 prior authorizations per physician per week — the highest cross-specialty average in medicine Read the guide →
- Radiology ~30% of outpatient imaging orders now require prior authorization Read the guide →
- Orthopedics 93% of physicians say prior authorization delays patient care — in orthopedics, a delayed surgery is a delayed return to function Read the guide →
- Pain Management 29% of physicians report prior authorization led to a serious adverse event — in pain management, delay often means escalating medication use Read the guide →
- Urology 82% of physicians say prior authorization can lead patients to abandon treatment — a familiar pattern in OAB step therapy Read the guide →
- Nephrology 29% of physicians report prior authorization led to a serious adverse event — in nephrology, a transplant patient's immunosuppressant lapse can mean rejection Read the guide →
- Physical Medicine & Rehabilitation 29% of physicians report prior authorization led to a serious adverse event — in PM&R, a denied wheelchair or delayed Botox is a functional one Read the guide →
- Reproductive Endocrinology & Fertility 15 states require IVF coverage; 25 have some fertility insurance law — outside mandate states, patients pay out of pocket or stop treatment Read the guide →