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PAYER POLICY CHANGES

E0272 Insurance Policy Changes

HCPCS E0272 is officially defined as "Mattress, foam rubber." HCPCS E0272 is referenced in 1 tracked payer policy change from BlueCross BlueShield of South Carolina. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS E0272 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 rules7
Payers requiring prior auth7
  • 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 in some cases

    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)

FREQUENTLY ASKED QUESTIONS

Does AmeriHealth Caritas require prior authorization for E0272?

AmeriHealth Caritas lists E0272 on AmeriHealth Caritas Louisiana Act 233 prior authorization service list for medicaid managed plans, with conditions. Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for E0272?

BCBS Michigan lists E0272 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 CalViva Health require prior authorization for E0272?

CalViva Health lists E0272 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 Colorado Medicaid require prior authorization for E0272?

Colorado Medicaid lists E0272 on Colorado Health First Colorado Fee Schedule (Prior Authorization Needed column) for medicaid ffs plans, with conditions (list dated July 1, 2026). Verify with the payer before scheduling.

Does Community Health Plan of Imperial Valley require prior authorization for E0272?

Community Health Plan of Imperial Valley lists E0272 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 E0272?

There are 1 tracked policy change affecting HCPCS E0272, including updates from BlueCross BlueShield of South Carolina. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS E0272?

Payers that have issued tracked updates for HCPCS E0272 include: BlueCross BlueShield of South Carolina.

How do I get notified when HCPCS E0272 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS E0272. 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 E0272?

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 E0272

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for E0272 in one place.

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