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37299

PAYER POLICY CHANGES

37299 Insurance Policy Changes

CPT 37299, in plain terms, covers Add-on for balloon angioplasty of one more artery below the ankle with a complex lesion, counted per extra vessel and billed along with the code for the first vessel treated. CPT 37299 is referenced in 9 tracked payer policy changes from Humana, CareSource, and 5 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 37299 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 37299 on AAPC

Humana · Effective Oct 1, 2026High impact
Peripheral Artery Revascularization of the Lower Extremities - Medicare Advantage (Revised)
Humana Medicare Advantage revised its Peripheral Artery Revascularization of the Lower Extremities policy effective October 1, 2026, establishing specific medical necessity criteria for lower extremity PTA with stenting, atherectomy, and intravascular ultrasound. The policy references applicable Local Coverage Determinations (LCDs) by MAC jurisdiction and outlines coverage for alternative revascularization methods including deep vein arterialization and percutaneous transmural arterial bypass.
CareSource · Effective Aug 1, 2026High impact
[Georgia] Prior Authorization Requirement Update
CareSource Georgia Medicaid is requiring prior authorization for 90+ new codes across multiple categories including durable medical equipment, hearing services, inpatient facility services, and outpatient diagnostics/services, effective August 1, 2026. Prior authorization will be mandatory for all nonparticipating providers and inpatient service requests.
Independence Blue Cross · Effective Jan 1, 2026High impact
MA11.056i, Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery
Independence Blue Cross MA11.056i policy on Percutaneous Transluminal Angioplasty (PTA) with carotid stenting has been reissued with annual updates to CPT/HCPCS codes effective January 1, 2026. Seven CPT codes were revised, five new codes were added (37254-37261, 37263-37278, 37280-37299, 92930, 92945), and seven codes were terminated (37220-37235, 92921, 92925, 92929, 92934, 92938, 92944). Coverage criteria remain unchanged but billing teams must update systems to reflect these code transitions.
Premera Blue Cross · Identified Jun 16, 2026High impact
Medical Policy and Coding Updates - January 2026
With effective dates from January 1, 2026 through April 8, 2026. The update adds medical necessity and prior authorization review for electrophysiology studies, endovascular stent grafts for abdominal aortic aneurysms, shoulder arthrotomy, shoulder arthroscopy, abdominal wall hernia repair, and hip, knee and spine surgeries for Standard and Basic Federal Employee Program plans, and it expands site of service ASC review to upper GI endoscopy and shoulder procedures. It also changes many drug criteria, including preferred product and quantity limit updates, adds Carelon review for advanced imaging, and lists codes that became non-covered, investigational or terminated.
Blue Cross & Blue Shield of Mississippi · Effective Apr 1, 2026Medium impact
Percutaneous Revascularization Procedures for Lower Extremity Peripheral Arterial Disease
Percutaneous revascularization using balloon angioplasty, stent procedures, or atherectomy for chronic symptomatic lower extremity peripheral arterial disease may be considered medically necessary when functionally limiting claudication is present, there is an inadequate response to guideline-directed management and therapy including structured exercise, and the potential benefits outweigh the risks and durability of the intervention. These same procedures may also be considered medically necessary for chronic limb-threatening ischemia and for acute limb ischemia, and percutaneous revascularization using lithotripsy is considered investigational in all situations. CPT codes 37220 through 37235 are marked deleted as of 12/31/2025, and CPT codes 37254 through 37299 are marked new as of 01/01/2026.
Indiana Medicaid (IHCP) · Effective Apr 1, 2026Medium impact
BT202678: Updated coverage and billing information for the April 2026 quarterly HCPCS codes update
The Indiana Health Coverage Programs (IHCP) set coverage and billing information for procedure codes in the April 2026 quarterly HCPCS update, effective for dates of service on or after April 1, 2026. This bulletin replaces the originally published update in IHCP Bulletin BT202649, and it sets prior authorization criteria for J3404, J9183, and the Q5161 and Q5162 biosimilars. Codes discontinued effective March 31, 2026 have no alternative codes identified by the IHCP, and codes marked allowed for podiatrists (provider specialty 140) are limited to that provider specialty.
Indiana Medicaid (IHCP) · Effective Jan 1, 2026Medium impact
BT2025188: Coverage and billing information for the 2026 annual HCPCS code update
Effective for dates of service on or after January 1, 2026, Indiana Medicaid lists the new CPT, CDT and other HCPCS codes from the 2026 annual HCPCS update as either covered or noncovered, and shows whether each one requires prior authorization or NDC. Codes discontinued in the update are listed with alternate code considerations, and the source states that inclusion of an alternate code does not indicate IHCP coverage of that alternate code. The IHCP is awaiting the final posting of the CMS fee schedules that set pricing for these codes, and reimbursement amounts will be posted on the Professional Fee Schedule and Outpatient Fee Schedule once pricing is established.
Indiana Medicaid (IHCP) · Effective Jan 1, 2026Medium impact
BT202630: Updated coverage and billing information for the 2026 annual HCPCS codes update
The Indiana Health Coverage Programs (IHCP) set coverage and billing information for procedure codes added in the 2026 annual HCPCS update, effective for dates of service on or after January 1, 2026. Codes marked covered in Table 1 do not require prior authorization, codes marked noncovered are not covered for any IHCP program, and C9307 and C9308 require an NDC. Discontinued codes are listed with alternate code considerations, and this bulletin replaces IHCP Bulletin BT2025188.
Aetna · Identified Aug 13, 2026Medium impact
Peripheral Atherectomy and Thrombectomy Devices (CPB 0295, reviewed 2026-04-16)
Aetna considers peripheral atherectomy of the renal artery, visceral artery, abdominal aorta, and brachiocephalic trunk and branches experimental, investigational, or unproven because its effectiveness has not been established. The same classification applies to the BYCROSS atherectomy device for peripheral arterial disease, intravascular shockwave lithotripsy for the listed peripheral arteries, celiac artery occlusion and renal artery stenosis, and isolated segmental pharmaco-mechanical thrombolysis (Trellis Peripheral Infusion System) for deep venous thrombosis, Paget-Schroetter syndrome, and other indications. Endovascular revascularization codes CPT 37220 through 37247 and 37254 through 37299 and drug-coated balloon catheter code HCPCS C2623 are covered when selection criteria are met, and medical necessity criteria for peripheral atherectomy are set in the EviCore Healthcare Peripheral Vascular Intervention Clinical Guidelines.

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REFERENCE DATA

Payers with rules3

Payers requiring prior auth3

Anthem BCBS · Effective November 1, 2026
Prior authorization required
Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)
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)
Cigna · Effective March 7, 2026
Prior authorization required
Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs (EviCore)

FREQUENTLY ASKED QUESTIONS

Does Anthem BCBS require prior authorization for 37299?

Anthem BCBS lists 37299 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 BCBS Michigan require prior authorization for 37299?

BCBS Michigan lists 37299 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 Cigna require prior authorization for 37299?

Cigna lists 37299 on Cigna Master Precertification List for commercial plans, with conditions (list dated October 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 37299?

There are 9 tracked policy changes affecting CPT 37299, including updates from Humana, CareSource, Independence Blue Cross. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 37299?

Payers that have issued tracked updates for CPT 37299 include: Humana, CareSource, Independence Blue Cross, Premera Blue Cross, Blue Cross & Blue Shield of Mississippi, Indiana Medicaid (IHCP), Aetna.

How do I get notified when CPT 37299 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 37299. 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 37299?

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.

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Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 37299 in one place.

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All billing codes J3590 C9399 J3490 99215 99213 99202

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Peripheral Artery Revascularization of the Lower Extremities - Medicare Advantage (Revised)

[Georgia] Prior Authorization Requirement Update

MA11.056i, Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery

Medical Policy and Coding Updates - January 2026

Percutaneous Revascularization Procedures for Lower Extremity Peripheral Arterial Disease

BT202678: Updated coverage and billing information for the April 2026 quarterly HCPCS codes update

BT2025188: Coverage and billing information for the 2026 annual HCPCS code update

BT202630: Updated coverage and billing information for the 2026 annual HCPCS codes update

Peripheral Atherectomy and Thrombectomy Devices (CPB 0295, reviewed 2026-04-16)

Prior authorization required

Prior authorization required in some cases