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PAYER POLICY CHANGES

65785 Insurance Policy Changes

CPT 65785, in plain terms, covers Surgeon implants an intrastromal corneal ring segment to correct refractive error or keratoconus. CPT 65785 is referenced in 3 tracked payer policy changes from Capital Blue Cross, 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 65785 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 65785 on AAPC

Watch 65785

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REFERENCE DATA

Payers with rules3
Payers requiring prior auth3
  • Cigna · Effective March 7, 2026

    Prior authorization required

    Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs (EviCore)

  • 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 65785?

CalViva Health lists 65785 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 Cigna require prior authorization for 65785?

Cigna lists 65785 on Cigna Master Precertification List for commercial plans (list dated October 1, 2026). Verify with the payer before scheduling.

Does Community Health Plan of Imperial Valley require prior authorization for 65785?

Community Health Plan of Imperial Valley lists 65785 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 65785?

There are 3 tracked policy changes affecting CPT 65785, including updates from Capital Blue Cross, Sentara Health Plans, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 65785?

Payers that have issued tracked updates for CPT 65785 include: Capital Blue Cross, Sentara Health Plans, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 65785 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 65785. 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 65785?

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 65785

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 65785 in one place.

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