Start free
PAYER POLICY CHANGES

C9064 Insurance Policy Changes

HCPCS C9064 is officially defined as "Mitomycin pyelocalyceal instillation, 1 mg." HCPCS C9064 is referenced in 1 tracked payer policy change from Indiana Medicaid (IHCP). For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS C9064 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Watch C9064

Get one email when a payer policy names C9064, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

No account needed. We send a confirmation link first, and every email has a one-click stop link.

REFERENCE DATA

Payers with rules3
Payers requiring prior auth3
  • 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)

  • 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 C9064?

AmeriHealth Caritas lists C9064 on AmeriHealth Caritas Louisiana Act 233 prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for C9064?

BCBS Michigan lists C9064 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 C9064?

Centene lists C9064 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 HCPCS C9064?

There are 1 tracked policy change affecting HCPCS C9064, including updates from Indiana Medicaid (IHCP). Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS C9064?

Payers that have issued tracked updates for HCPCS C9064 include: Indiana Medicaid (IHCP).

How do I get notified when HCPCS C9064 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS C9064. 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 C9064?

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 C9064

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for C9064 in one place.

See every payer rule

RELATED

All billing codesJ3590C9399J3490992159921399202

Get alerts for changes like this

Save a search and get email alerts when a new policy change matches your filters: daily or weekly, your choice, on every plan.

Create a free alertHow Policy Monitoring works