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PAYER POLICY CHANGES

59898 Insurance Policy Changes

CPT 59898 is referenced in 2 tracked payer policy changes from Healthfirst. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 59898 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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REFERENCE DATA

Payers with rules3
Payers requiring prior auth3
  • 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)

  • CountyCare Health Plan · Effective April 23, 2026

    Prior authorization required

    CountyCare Prior Authorization Look-Up Tool (All Codes)

FREQUENTLY ASKED QUESTIONS

Does AmeriHealth Caritas require prior authorization for 59898?

AmeriHealth Caritas lists 59898 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 59898?

BCBS Michigan lists 59898 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 CountyCare Health Plan require prior authorization for 59898?

CountyCare Health Plan lists 59898 on CountyCare Prior Authorization Look-Up Tool (All Codes) for medicaid managed plans (list dated April 23, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 59898?

There are 2 tracked policy changes affecting CPT 59898, including updates from Healthfirst. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 59898?

Payers that have issued tracked updates for CPT 59898 include: Healthfirst.

How do I get notified when CPT 59898 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 59898. 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 59898?

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 59898

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 59898 in one place.

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