What insurance policy changes affect CPT 91110?

There are 9 tracked policy changes affecting CPT 91110, including updates from Priority Health, Humana, NY Medicaid. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 91110?

Payers that have issued tracked updates for CPT 91110 include: Priority Health, Humana, NY Medicaid, Excellus BlueCross BlueShield.

How do I get notified when CPT 91110 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 91110. You will receive a daily digest email whenever a new policy change references this code.

Why do payers change policies for CPT 91110?

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.

91110 — A test where a tiny camera is passed down your throat to examine the tissues of your esophagus and stomach.: Insurance Policy Changes

91110 Insurance Policy Changes

CPT 91110, in plain terms, covers A test where a tiny camera is passed down your throat to examine the tissues of your esophagus and stomach. CPT 91110 is referenced in 9 tracked payer policy changes from Priority Health, Humana, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 91110 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact

May medical policy updates

Priority Health·Effective Jun 1, 2026

Priority Health is implementing extensive medical policy updates effective June 1, 2026, affecting multiple specialties including retirement of apnea monitor and bronchial thermoplasty policies, expanded coverage for balloon sinus procedures, new prior authorization requirements for certain surgeries, and changes to durable medical equipment coverage including making CPM devices no longer covered.

91110 Insurance Policy Changes

May medical policy updates

Capsule Endoscopy - Medicare Advantage (Revised)

NYRx Pharmacy Drug Coverage: Claims Processing Enhancements and Reminders

NYS Medicaid FFS Billing

Update to the New York State Patient Centered Medical Home Billing Guidance

Capsule Endoscopy 6.01.27

2026 Spousal Impoverishment Income and Resource Levels Increase

New York State Medicaid Updated Coverage Criteria for Wireless Capsule Endoscopy

Medicaid Breast Cancer Surgery Centers