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PAYER POLICY CHANGES

A9555 Insurance Policy Changes

HCPCS A9555 is officially defined as "Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries." HCPCS A9555 is referenced in 3 tracked payer policy changes from Excellus BlueCross BlueShield, Blue Cross & Blue Shield of Mississippi, and 1 other payer. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS A9555 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 rules2
Payers requiring prior auth2
  • 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 CalViva Health require prior authorization for A9555?

CalViva Health lists A9555 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 A9555?

Community Health Plan of Imperial Valley lists A9555 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 HCPCS A9555?

There are 3 tracked policy changes affecting HCPCS A9555, including updates from Excellus BlueCross BlueShield, Blue Cross & Blue Shield of Mississippi, Aetna. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS A9555?

Payers that have issued tracked updates for HCPCS A9555 include: Excellus BlueCross BlueShield, Blue Cross & Blue Shield of Mississippi, Aetna.

How do I get notified when HCPCS A9555 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS A9555. 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 A9555?

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 A9555

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for A9555 in one place.

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