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PAYER POLICY CHANGES

93153 Insurance Policy Changes

CPT 93153, in plain terms, covers Interrogation of an implanted phrenic nerve stimulation system for central sleep apnea, without programming changes. CPT 93153 is referenced in 5 tracked payer policy changes from Blue Cross Blue Shield of North Dakota, Humana, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 93153 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Official descriptor: CPT 93153 on AAPC

Watch 93153

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REFERENCE DATA

Payers with rules3
Payers requiring prior auth3
  • Anthem BCBS · Effective November 1, 2026

    Prior authorization required

    Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial)

  • Elevance Health · Effective February 11, 2026

    Prior authorization required

    List of items and services that require prior authorization (Elevance CMS-0057-F list)

  • 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 Anthem BCBS require prior authorization for 93153?

Anthem BCBS lists 93153 on Anthem Local PPO Precertification/Prior Authorization List (California | Anthem Blue Cross | Commercial) for commercial plans (list dated November 1, 2026). Verify with the payer before scheduling.

Does Centene require prior authorization for 93153?

Centene lists 93153 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 Elevance Health require prior authorization for 93153?

Elevance Health lists 93153 on List of items and services that require prior authorization (Elevance CMS-0057-F list) for medicare advantage plans (list dated February 11, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 93153?

There are 5 tracked policy changes affecting CPT 93153, including updates from Blue Cross Blue Shield of North Dakota, Humana, 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 93153?

Payers that have issued tracked updates for CPT 93153 include: Blue Cross Blue Shield of North Dakota, Humana, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 93153 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 93153. 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 93153?

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 93153

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 93153 in one place.

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