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PAYER POLICY CHANGES

15845 Insurance Policy Changes

CPT 15845, in plain terms, covers Surgeon performs a regional muscle transfer, such as temporalis or masseter, to the face to treat facial nerve paralysis. CPT 15845 is referenced in 1 tracked payer policy change from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 15845 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 15845 on AAPC

Watch 15845

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REFERENCE DATA

Payers with rules7
Payers requiring prior auth7
  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

    Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)

  • Colorado Medicaid · Effective July 1, 2026

    Prior authorization required

    Colorado Health First Colorado Fee Schedule (Prior Authorization Needed column)

  • Elevance Health · Effective February 11, 2026

    Prior authorization required

    List of items and services that require prior authorization (Medicaid GA)

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for 15845?

Ambetter lists 15845 on Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Anthem BCBS require prior authorization for 15845?

Anthem BCBS lists 15845 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for 15845?

CalViva Health lists 15845 on CalViva Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Colorado Medicaid require prior authorization for 15845?

Colorado Medicaid lists 15845 on Colorado Health First Colorado Fee Schedule (Prior Authorization Needed column) for medicaid ffs plans (list dated July 1, 2026). Verify with the payer before scheduling.

Does Community Health Plan of Imperial Valley require prior authorization for 15845?

Community Health Plan of Imperial Valley lists 15845 on Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

What insurance policy changes affect CPT 15845?

There are 1 tracked policy change affecting CPT 15845, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 15845?

Payers that have issued tracked updates for CPT 15845 include: Aetna.

How do I get notified when CPT 15845 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 15845. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for CPT 15845?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

See every payer rule for 15845

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 15845 in one place.

See every payer rule

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