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PAYER POLICY CHANGES

94799 Insurance Policy Changes

CPT 94799 is referenced in 1 tracked payer policy change from Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 94799 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 rules9
Payers requiring prior auth9
  • BCBS Michigan · Effective October 13, 2026

    Prior authorization required in some cases

    BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines)

  • CountyCare Health Plan · Effective April 23, 2026

    Prior authorization required

    CountyCare Prior Authorization Look-Up Tool (All Codes)

  • Cigna · Effective March 7, 2026

    Prior authorization required

    Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs (EviCore)

FREQUENTLY ASKED QUESTIONS

Does AmeriHealth Caritas require prior authorization for 94799?

AmeriHealth Caritas lists 94799 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does Arizona Complete Health require prior authorization for 94799?

Arizona Complete Health lists 94799 on Arizona Complete Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for 94799?

BCBS Michigan lists 94799 on BCBSM and BCN procedure codes for which providers must request prior authorization (commercial lines) for commercial plans, with conditions (list dated October 13, 2026). Verify with the payer before scheduling.

Does CalViva Health require prior authorization for 94799?

CalViva Health lists 94799 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 Centene require prior authorization for 94799?

Centene lists 94799 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.

What insurance policy changes affect CPT 94799?

There are 1 tracked policy change affecting CPT 94799, including updates from 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 94799?

Payers that have issued tracked updates for CPT 94799 include: Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 94799 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 94799. 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 94799?

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 94799

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 94799 in one place.

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