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PAYER POLICY CHANGES

A7049 Insurance Policy Changes

HCPCS A7049 is officially defined as "Expiratory positive airway pressure intranasal resistance valve." HCPCS A7049 is referenced in 1 tracked payer policy change from Medicare/CMS - Transmittals. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS A7049 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
  • 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)

  • Colorado Medicaid · Effective July 1, 2026

    Prior authorization required

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

  • 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 A7049?

AmeriHealth Caritas lists A7049 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for A7049?

BCBS Michigan lists A7049 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 Centene require prior authorization for A7049?

Centene lists A7049 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 A7049?

Colorado Medicaid lists A7049 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.

What insurance policy changes affect HCPCS A7049?

There are 1 tracked policy change affecting HCPCS A7049, including updates from Medicare/CMS - Transmittals. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS A7049?

Payers that have issued tracked updates for HCPCS A7049 include: Medicare/CMS - Transmittals.

How do I get notified when HCPCS A7049 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS A7049. 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 A7049?

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 A7049

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for A7049 in one place.

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