Treatment Authorizations & Variances Requests

Medical providers should submit their Attending Doctor's Request for Authorization (C-4Auth) requests and Medical Treatment Guideline (MTG) Variance Requests, forms MG-2 and MG-2.1, to the MTG teams in their respective NYSIF business offices. Please note your respective NYSIF business office e-mail, fax and claim unit numbers provided below:

NYSIF Medical Treatment Authorization and Variance Request Teams
Office MTG Shared E-mail Box MTG Shared Fax Claim Units
BRONX
QUEENS (BQ)
mtg-brxqueens@nysif.com (212) 312-7470 24, 28, 29, 368, 369, 370, 371, 372, 373, 374, 381
BROOKLYN/STATEN ISLAND (B-SI) mtg-bklynsi@nysif.com (212) 312-7938 20, 301, 302, 303, 304, 305, 306, 307, 308, 311, 315
LOWER MANHATTAN (LM) mtg-lowerman@nysif.com (212)-587-9294 321, 322, 323, 324, 325, 326, 327, 328, 329, 331
UPPER MANHATTAN (UM) mtg-upperman@nysif.com (212) 587-9295 50, 52, 53, 54, 57, 58, 59, 150, 204, 361, 362, 363, 364, 365, 366, 367
NASSAU mtg-nassau@nysif.com (631) 756-4206 100, 102, 104, 105, 106, 107, 108, 109, 110, 111, 113, 114, 116, 117, 118, 119, 121, 122, 123, 124, 125, 126, 127, 129, 141, 142, 199, 213
SUFFOLK mtg-suffolk@nysif.com (631) 756-4272 55, 217, 235, 236, 237, 238, 239, 240, 241, 242, 243, 244, 245, 246, 247, 248, 249, 250, 251, 252, 253, 254, 255, 256, 257, 260, 261, 262, 263
WHITE PLAINS mtg-whiteplains@nysif.com
(914) 701-2188 145, 153, 154, 155, 156, 157, 162, 163, 164, 165, 166, 167, 168, 169, 170, 171, 172, 173, 174, 175, 176, 177, 179, 190, 191, 215, 225
ALBANY mtg-albany@nysif.com (518) 437-8997 25, 90, 91, 92, 93, 94, 95, 96, 97, 98, 99, 180, 181, 182, 183, 184, 185, 212, 222
BUFFALO mtg-buffalo@nysif.com (716) 851-2096 80, 81, 82, 83, 84, 85, 86, 89, 140, 146, 202, 205, 206, 207, 208, 209, 218
ROCHESTER mtg-rochester@nysif.com (585) 258-2004 70, 71, 72, 74, 77, 78, 79, 216
SYRACUSE mtg-syracuse@nysif.com
(315) 453-8337 60, 61, 62, 63, 66, 67, 130, 131, 132, 133, 138, 139, 214, 224
BINGHAMTON mtg-binghamton@nysif.com
(607) 741-5605 281, 282, 283, 284, 285, 286, 287, 288, 289

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