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PAYER POLICY CHANGES

76145 Insurance Policy Changes

CPT 76145 is referenced in 1 tracked payer policy change from Indiana Medicaid (IHCP). For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 76145 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Watch 76145

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REFERENCE DATA

Payers with rules4
Payers requiring prior auth4
  • CountyCare Health Plan · Effective April 23, 2026

    Prior authorization required in some cases

    CountyCare Prior Authorization Look-Up Tool (All Codes)

  • Ambetter · Effective December 31, 2025

    Prior authorization required

    Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements

  • Centene · Effective December 31, 2025

    Prior authorization required

    Sunshine Health Title XIX, Title XXI, Managed Medical Assistance CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for 76145?

Ambetter lists 76145 on Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Centene require prior authorization for 76145?

Centene lists 76145 on Sunshine Health Title XIX, Title XXI, Managed Medical Assistance 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 76145?

CountyCare Health Plan lists 76145 on CountyCare Prior Authorization Look-Up Tool (All Codes) for medicaid managed plans, with conditions (list dated April 23, 2026). Verify with the payer before scheduling.

Does Fidelis Care require prior authorization for 76145?

Fidelis Care lists 76145 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 76145?

There are 1 tracked policy change affecting CPT 76145, including updates from Indiana Medicaid (IHCP). Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 76145?

Payers that have issued tracked updates for CPT 76145 include: Indiana Medicaid (IHCP).

How do I get notified when CPT 76145 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 76145. 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 76145?

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 76145

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 76145 in one place.

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