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PAYER POLICY CHANGES

94667 Insurance Policy Changes

CPT 94667 is referenced in 1 tracked payer policy change from Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 94667 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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REFERENCE DATA

Payers with rules4
Payers requiring prior auth4
  • Anthem BCBS · Effective October 19, 2026

    Prior authorization required

    Anthem local precertification/prior authorization list (Colorado | Anthem Blue Cross and Blue Shield | Commercial)

  • 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 Anthem BCBS require prior authorization for 94667?

Anthem BCBS lists 94667 on Anthem local precertification/prior authorization list (Colorado | Anthem Blue Cross and Blue Shield | Commercial) for commercial plans (list dated October 19, 2026). Verify with the payer before scheduling.

Does BCBS Illinois require prior authorization for 94667?

BCBS Illinois lists 94667 on Blue Cross Community Health Plans (Illinois Medicaid) Prior Authorization Code List for medicaid managed plans, with conditions (list dated October 1, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for 94667?

CalViva Health lists 94667 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 94667?

Community Health Plan of Imperial Valley lists 94667 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 94667?

There are 1 tracked policy change affecting CPT 94667, including updates from Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 94667?

Payers that have issued tracked updates for CPT 94667 include: Aetna.

How do I get notified when CPT 94667 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 94667. 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 94667?

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 94667

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 94667 in one place.

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