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PAYER POLICY CHANGES

A6591 Insurance Policy Changes

HCPCS A6591 is officially defined as "External urinary catheter; non-disposable, for use with suction pump, per month." HCPCS A6591 is referenced in 2 tracked payer policy changes from Medicare/CMS - Transmittals and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS A6591 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
  • Colorado Medicaid · Effective July 1, 2026

    Prior authorization required

    Colorado Health First Colorado Fee Schedule (Prior Authorization Needed column)

  • CountyCare Health Plan · Effective April 23, 2026

    Prior authorization required

    CountyCare Prior Authorization Look-Up Tool (All Codes)

  • 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 AmeriHealth Caritas require prior authorization for A6591?

AmeriHealth Caritas lists A6591 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans, with conditions. Verify with the payer before scheduling.

Does Centene require prior authorization for A6591?

Centene lists A6591 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 Colorado Medicaid require prior authorization for A6591?

Colorado Medicaid lists A6591 on Colorado Health First Colorado Fee Schedule (Prior Authorization Needed column) for medicaid ffs plans (list dated July 1, 2026). Verify with the payer before scheduling.

Does CountyCare Health Plan require prior authorization for A6591?

CountyCare Health Plan lists A6591 on CountyCare Prior Authorization Look-Up Tool (All Codes) for medicaid managed plans (list dated April 23, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS A6591?

There are 2 tracked policy changes affecting HCPCS A6591, including updates from Medicare/CMS - Transmittals, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS A6591?

Payers that have issued tracked updates for HCPCS A6591 include: Medicare/CMS - Transmittals, Aetna.

How do I get notified when HCPCS A6591 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS A6591. 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 HCPCS A6591?

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 A6591

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for A6591 in one place.

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