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PAYER POLICY CHANGES

65781 Insurance Policy Changes

CPT 65781, in plain terms, covers Surgeon reconstructs the ocular surface by transplanting donor limbal stem cells. CPT 65781 is referenced in 4 tracked payer policy changes from Excellus BlueCross BlueShield, Sentara Health Plans, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 65781 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 65781 on AAPC

Watch 65781

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REFERENCE DATA

Payers with rules5
Payers requiring prior auth5
  • CountyCare Health Plan · Effective April 23, 2026

    Prior authorization required

    CountyCare Prior Authorization Look-Up Tool (All Codes)

  • CalViva Health · Effective December 31, 2025

    Prior authorization required

    CalViva Health CMS-0057-F prior authorization requirements

  • Community Health Plan of Imperial Valley · Effective December 31, 2025

    Prior authorization required

    Community Health Plan of Imperial Valley CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does CalViva Health require prior authorization for 65781?

CalViva Health lists 65781 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 Capital Blue Cross require prior authorization for 65781?

Capital Blue Cross lists 65781 on Capital Blue Cross single source preauthorization code list for commercial plans. Verify with the payer before scheduling.

Does Community Health Plan of Imperial Valley require prior authorization for 65781?

Community Health Plan of Imperial Valley lists 65781 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.

Does CountyCare Health Plan require prior authorization for 65781?

CountyCare Health Plan lists 65781 on CountyCare Prior Authorization Look-Up Tool (All Codes) for medicaid managed plans (list dated April 23, 2026). Verify with the payer before scheduling.

Does Fidelis Care require prior authorization for 65781?

Fidelis Care lists 65781 on Fidelis Care 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 65781?

There are 4 tracked policy changes affecting CPT 65781, including updates from Excellus BlueCross BlueShield, Sentara Health Plans, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 65781?

Payers that have issued tracked updates for CPT 65781 include: Excellus BlueCross BlueShield, Sentara Health Plans, Aetna.

How do I get notified when CPT 65781 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 65781. 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 65781?

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 65781

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 65781 in one place.

See every payer rule

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