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PAYER POLICY CHANGES

C1601 Insurance Policy Changes

HCPCS C1601 is officially defined as "Endoscope, single-use (i.e. disposable), pulmonary, imaging/illumination device (insertable)." HCPCS C1601 is referenced in 1 tracked payer policy change from BCBS Arizona. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS C1601 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 rules3
Payers requiring prior auth3
  • Fidelis Care · Effective November 1, 2026

    Prior authorization required in some cases

    Fidelis Care Metal-Level Products authorization grid

  • Centene · Effective December 31, 2025

    Prior authorization required

    Sunshine Health Title XIX, Title XXI, Managed Medical Assistance CMS-0057-F prior authorization requirements

  • Coordinated Care · Effective December 31, 2025

    Prior authorization required

    Coordinated Care CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Centene require prior authorization for C1601?

Centene lists C1601 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 Coordinated Care require prior authorization for C1601?

Coordinated Care lists C1601 on Coordinated Care CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does Fidelis Care require prior authorization for C1601?

Fidelis Care lists C1601 on Fidelis Care Metal-Level Products authorization grid for exchange plans, with conditions (list dated November 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS C1601?

There are 1 tracked policy change affecting HCPCS C1601, including updates from BCBS Arizona. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS C1601?

Payers that have issued tracked updates for HCPCS C1601 include: BCBS Arizona.

How do I get notified when HCPCS C1601 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS C1601. 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 C1601?

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 C1601

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for C1601 in one place.

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