Does Community Health Plan of Imperial Valley require prior authorization for 59400?
Community Health Plan of Imperial Valley lists 59400 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 59400?
There are 27 tracked policy changes affecting CPT 59400, including updates from Blue Cross Blue Shield of Vermont, Michigan Medicaid - MDHHS, Indiana Medicaid (IHCP). Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.
Which payers have updated policy for CPT 59400?
Payers that have issued tracked updates for CPT 59400 include: Blue Cross Blue Shield of Vermont, Michigan Medicaid - MDHHS, Indiana Medicaid (IHCP), Healthfirst, Nebraska Medicaid, Excellus BlueCross BlueShield, MassHealth, Arkansas Medicaid, Harvard Pilgrim Health Care, NY Medicaid, Oregon Health Plan, Wisconsin Medicaid (ForwardHealth), New Mexico Medicaid, Wisconsin ForwardHealth, Aetna, Medical Mutual of Ohio, Colorado Medicaid, L.A. Care Health Plan, Blue Cross Blue Shield of Rhode Island, Blue Cross of Idaho.
How do I get notified when CPT 59400 policy changes?
Create a free account at PolicyChanges.app and save a search filtered to CPT 59400. 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 59400?
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.