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PAYER POLICY CHANGES

36836 Insurance Policy Changes

CPT 36836, in plain terms, covers Percutaneous creation of an upper extremity arteriovenous fistula for dialysis through a single access site for both artery and vein, with all imaging guidance included. CPT 36836 is referenced in 4 tracked payer policy changes from HealthPartners and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 36836 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 36836 on AAPC

Watch 36836

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REFERENCE DATA

Payers with rules7
Payers requiring prior auth7
  • BCBS Michigan · Effective October 13, 2026

    Prior authorization required in some cases

    BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines)

  • Ambetter · Effective December 31, 2025

    Prior authorization required

    Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements

  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for 36836?

Ambetter lists 36836 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 AmeriHealth Caritas require prior authorization for 36836?

AmeriHealth Caritas lists 36836 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for 36836?

BCBS Michigan lists 36836 on BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines) for commercial plans, with conditions (list dated October 13, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for 36836?

CalViva Health lists 36836 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 Centene require prior authorization for 36836?

Centene lists 36836 on Sunshine Health Title XIX, Title XXI, Managed Medical Assistance 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 36836?

There are 4 tracked policy changes affecting CPT 36836, including updates from HealthPartners, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 36836?

Payers that have issued tracked updates for CPT 36836 include: HealthPartners, Aetna.

How do I get notified when CPT 36836 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 36836. 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 36836?

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 36836

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 36836 in one place.

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