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Billing codes
92517

PAYER POLICY CHANGES

92517 Insurance Policy Changes

CPT 92517, in plain terms, covers The clinician records vestibular evoked myogenic potentials from cervical muscles to assess vestibular function. CPT 92517 is referenced in 10 tracked payer policy changes from Excellus BlueCross BlueShield, Sentara Health Plans, and 3 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 92517 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 92517 on AAPC

Excellus BlueCross BlueShield · Effective May 21, 2026Medium impact
Evoked Potentials 2.01.27
Policy 2.01.27 sets the indications considered medically appropriate for visual-evoked, somatosensory-evoked and auditory-evoked potentials, with a current effective date of May 21, 2026. Intra-operative neurophysiologic monitoring is considered medically appropriate during high-risk thyroid or parathyroid surgery, or during spinal, intracranial or vascular procedures, and all other indications for intra-operative neurophysiologic monitoring are considered not medically necessary. Vestibular evoked myogenic potentials, intra-operative monitoring of visual-evoked potentials, visual-evoked potential testing for glaucoma, and transcranial magnetic stimulation to elicit motor-evoked potentials are considered investigational.
Sentara Health Plans · Effective Feb 1, 2026Medium impact
Authorization Updates - Effective Feb, Mar, April, and May 2026
Sentara Health Plans removed prior authorization for code 88271 for Medicaid, Medicare and commercial products in Virginia effective February 1, 2026. Further codes stopped requiring prior authorization on March 1, 2026 and April 1, 2026, with separate lists for each product type; the commercial March 1 list includes codes such as 96422, 47382 and 61550, and the commercial April 1 list includes 23474 and 53860. Effective May 1, 2026, commercial products require prior authorization for codes including 53430, K0669, K0730 and a list of hearing aid codes such as V5010 and V5030.
Sentara Health Plans · Effective Feb 1, 2026Medium impact
Authorization Updates - Effective February 1, 2026
Effective February 1, 2026, Sentara Health Plans stopped requiring prior authorization or precertification for a long list of procedures and services for Medicare products and for Medicaid products offered in Virginia. The lists include breast reconstruction codes 19357, 19361 and 19364, glenohumeral arthrodesis codes 23800 and 23802, cranial neurostimulation codes 61885 and 61886, and MR elastography code 76391. The notice also lists ocular, ENT, cardiac, genetic testing and home management codes among those no longer requiring authorization.
Harvard Pilgrim Health Care · Effective Nov 1, 2025Medium impact
Point32Health Medical Necessity Guideline updates
Point32Health is updating their Medical Necessity Guidelines effective November 1, 2025, making several services non-covered (autism interventions, Alzheimer's blood tests, ReActiv8 neurostimulation) while removing prior authorization requirements for tuberculosis testing, VEMP testing, and Cologuard Plus. Some codes will now require specific diagnosis codes for coverage.
Aetna · Identified Oct 1, 2026Medium impact
Endolymphatic Hydrops (Meniere's Disease) Tests (CPB 0571, reviewed 2026-09-01)
Aetna considers dehydration testing with glycerol, urea, or other osmotic diuretics medically necessary to verify suspected endolymphatic hydrops (Meniere's disease) only in members with atypical presentations of the disease, and considers it experimental, investigational, or unproven for other indications. Aetna considers the following experimental, investigational, or unproven: endolymphatic sac immunohistochemistry of aquaporin-2, V2R, NKCC2 and TRPV4; genetic testing of KCNE1, KCNE3, SIK1, SLC8A1 and SLC26A4 for this diagnosis; intravenous gadolinium inner ear MRI; multi-frequency tympanometry; testing for antibodies against inner ear antigens; vestibular evoked myogenic potential (VEMP) testing for diagnosis and for monitoring disease progression; and the video head impulse test. The policy lists CPT codes 81406, 92517, 92518, 92519, 92550, 92567 and 92584 and HCPCS code A9579 as not covered for the indications listed, and ICD-10 codes for Meniere's disease, related vertigo, labyrinthitis, gait abnormalities and dizziness are covered if selection criteria are met.
Aetna · Identified Aug 15, 2026Medium impact
Cochlear Implants and Auditory Brainstem Implants (CPB 0013, reviewed 2026-03-05)
Aetna considers unilateral or bilateral cochlear implantation medically necessary for adults 18 and older with bilateral, pre- or post-linguistic, sensorineural, moderate-to-profound hearing impairment who have a pure-tone average of 60 dB HL or greater at 500, 1000 and 2000 Hz and limited benefit from appropriately fitted hearing aids. It considers implantation medically necessary for infants and children with severe to profound bilateral sensorineural hearing loss (pure-tone average of 70 dB HL or greater) who have limited benefit from binaural hearing aids, and for individuals aged 1 year and older with single-sided deafness or asymmetric hearing loss who meet the stated criteria. Hybrid cochlear implants such as the Nucleus Hybrid L24 are considered medically necessary for adults 18 and older with the stated high-frequency hearing loss pattern. An auditory brainstem implant is considered medically necessary for members 12 years of age or older who have lost both auditory nerves due to disease or bilateral surgical removal of auditory nerve tumors. Cochlear implantation for auditory dyssynchrony, auditory neuropathy spectrum disorder, tinnitus and all other indications not meeting these criteria is considered experimental, investigational or unproven.
Aetna · Identified Aug 14, 2026Medium impact
Evoked Potential Studies (CPB 0181, reviewed 2026-04-21)
Aetna's Clinical Policy Bulletin 0181 sets out which evoked potential studies are medically necessary and which are experimental, investigational or unproven. Somatosensory evoked potentials are medically necessary to evaluate acute anoxic encephalopathy within 3 days of the anoxic event, suspected brain death, and clinically silent brain lesions in multiple sclerosis suspects, among other listed indications. Visual evoked potentials are medically necessary to diagnose and monitor multiple sclerosis, and brainstem auditory evoked responses are medically necessary to diagnose suspected acoustic neuroma and to screen infants and children under 3 years of age for hearing loss. Cervical vestibular evoked myogenic potentials are medically necessary for vertigo from semicircular canal dehiscence syndrome after a comprehensive evaluation with inconclusive results, and for bilateral sensorineural hearing loss after cochlear implantation. Pre-operative somatosensory evoked potentials of the bilateral tibial pathways before scoliosis surgery and somatosensory evoked potentials for carpal tunnel syndrome are listed as experimental, investigational or unproven.
Aetna · Identified Aug 14, 2026Medium impact
Endolymphatic Hydrops (Meniere's Disease) Tests (CPB 0571, reviewed 2025-12-02)
Aetna considers dehydration testing with glycerol, urea, or other osmotic diuretics medically necessary to verify suspected endolymphatic hydrops (Meniere's disease) only in members with atypical presentations, and considers it experimental, investigational, or unproven for other indications. The policy also lists as experimental, investigational, or unproven: endolymphatic sac immunohistochemistry, genetic testing of KCNE1, KCNE3, SIK1, SLC8A1, and SLC26A4 for diagnosis, intravenous gadolinium inner ear MRI, multi-frequency tympanometry, testing for antibodies against inner ear antigens, VEMP for diagnosis and for monitoring disease progression, and the video head impulse test.
Aetna · Identified Aug 14, 2026Medium impact
Chronic Vertigo (CPB 0238, reviewed 2026-04-23)
Aetna considers the Epley and Semont maneuvers medically necessary for benign paroxysmal positional vertigo only when a positive Hallpike test confirms the diagnosis and the member has had symptoms for at least 4 months, and considers them experimental for members with central nervous system disorders such as temporal lobe epilepsy, multiple sclerosis, cerebrovascular disease, or cerebellar lesions. Vestibular rehabilitation is medically necessary for chronic vertigo or persistent postural-perceptual dizziness when symptoms have lasted more than 6 months, a vestibular disorder is confirmed or ablative vestibular surgery was performed, and medical management has failed. Dynamic posturography, the Meniett device, the DizzyFix, the GyroStim machine, the Biodex BioSway, the BTrackS system, and posterior semicircular canal occlusion are listed as experimental, investigational, or unproven.
Indiana Medicaid (IHCP) · Identified Jun 19, 2026Medium impact
BT202158: IHCP updates Outpatient Fee Schedule
The IHCP reviewed the Outpatient Fee Schedule, found discrepancies, and will reflect the changes in the next regular update to that schedule. Codes listed twice on previous versions will appear only once, codes missing from the schedule are covered in the outpatient setting and can be billed for dates of service on or after the date listed for each code, and other listed codes are noncovered and will be added to the schedule. Codes that have been nationally end dated will be removed from the schedule, and Current Dental Terminology (CDT) codes cannot be billed on institutional claims (UB-04 claim form or electronic equivalent).

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REFERENCE DATA

Payers with rules3

Payers requiring prior auth3

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
Fidelis Care · Effective December 31, 2025
Prior authorization required
Fidelis Care CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does CalViva Health require prior authorization for 92517?

CalViva Health lists 92517 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 92517?

Community Health Plan of Imperial Valley lists 92517 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 Fidelis Care require prior authorization for 92517?

Fidelis Care lists 92517 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 92517?

There are 10 tracked policy changes affecting CPT 92517, including updates from Excellus BlueCross BlueShield, Sentara Health Plans, Harvard Pilgrim Health Care. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 92517?

Payers that have issued tracked updates for CPT 92517 include: Excellus BlueCross BlueShield, Sentara Health Plans, Harvard Pilgrim Health Care, Aetna, Indiana Medicaid (IHCP).

How do I get notified when CPT 92517 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 92517. 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 92517?

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.

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Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 92517 in one place.

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All billing codes J3590 C9399 J3490 99215 99213 99202

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Evoked Potentials 2.01.27

Authorization Updates - Effective Feb, Mar, April, and May 2026

Authorization Updates - Effective February 1, 2026

Point32Health Medical Necessity Guideline updates

Endolymphatic Hydrops (Meniere's Disease) Tests (CPB 0571, reviewed 2026-09-01)

Cochlear Implants and Auditory Brainstem Implants (CPB 0013, reviewed 2026-03-05)

Evoked Potential Studies (CPB 0181, reviewed 2026-04-21)

Endolymphatic Hydrops (Meniere's Disease) Tests (CPB 0571, reviewed 2025-12-02)

Chronic Vertigo (CPB 0238, reviewed 2026-04-23)

BT202158: IHCP updates Outpatient Fee Schedule

Prior authorization required

Prior authorization required

Prior authorization required

Does CalViva Health require prior authorization for 92517?

Does Community Health Plan of Imperial Valley require prior authorization for 92517?

Does Fidelis Care require prior authorization for 92517?

What insurance policy changes affect CPT 92517?

Which payers have updated policy for CPT 92517?

How do I get notified when CPT 92517 policy changes?

Why do payers change policies for CPT 92517?