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PAYER POLICY CHANGES

92270 Insurance Policy Changes

CPT 92270, in plain terms, covers Electro-oculography that records eye movement electrical potentials using electrodes near the eye, with interpretation and report. CPT 92270 is referenced in 5 tracked payer policy changes from Wisconsin Medicaid (ForwardHealth), Wisconsin ForwardHealth, and 2 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 92270 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 92270 on AAPC

Watch 92270

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REFERENCE DATA

Payers with rules3
Payers requiring prior auth3
  • Ambetter · Effective December 31, 2025

    Prior authorization required

    Ambetter Health of Delaware CMS-0057-F prior authorization requirements

  • 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 Ambetter require prior authorization for 92270?

Ambetter lists 92270 on Ambetter Health of Delaware CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for 92270?

CalViva Health lists 92270 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 Community Health Plan of Imperial Valley require prior authorization for 92270?

Community Health Plan of Imperial Valley lists 92270 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 92270?

There are 5 tracked policy changes affecting CPT 92270, including updates from Wisconsin Medicaid (ForwardHealth), Wisconsin ForwardHealth, Aetna Better Health of Virginia. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 92270?

Payers that have issued tracked updates for CPT 92270 include: Wisconsin Medicaid (ForwardHealth), Wisconsin ForwardHealth, Aetna Better Health of Virginia, Aetna.

How do I get notified when CPT 92270 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 92270. 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 92270?

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 92270

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 92270 in one place.

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RELATED

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