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PAYER POLICY CHANGES

E0791 Insurance Policy Changes

HCPCS E0791 is officially defined as "Parenteral infusion pump, stationary, single or multi-channel." HCPCS E0791 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 E0791 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Watch E0791

Get one email when a payer policy names E0791, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

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REFERENCE DATA

Payers with rules13
Payers requiring prior auth13
  • 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)

  • Florida Blue · Effective March 27, 2026

    Prior authorization required

    Prior Authorization List: HMO – Marketplace Qualified Health Plans

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for E0791?

Ambetter lists E0791 on Ambetter from Arizona Complete Health CMS-0057-F prior authorization requirements for exchange plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does AmeriHealth Caritas require prior authorization for E0791?

AmeriHealth Caritas lists E0791 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans. Verify with the payer before scheduling.

Does BCBS Illinois require prior authorization for E0791?

BCBS Illinois lists E0791 on 2026 Commercial Outpatient Medical Surgical Prior Authorization Codes for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

Does BCBS Montana require prior authorization for E0791?

BCBS Montana lists E0791 on 2026 Commercial Medical Surgical Prior Authorization Codes for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

Does BCBS New Mexico require prior authorization for E0791?

BCBS New Mexico lists E0791 on 2026 Commercial Outpatient Medical Surgical ASO Medical Surgical Procedure Code List for commercial plans, with conditions (list dated January 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS E0791?

There are 1 tracked policy change affecting HCPCS E0791, 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 E0791?

Payers that have issued tracked updates for HCPCS E0791 include: Indiana Medicaid (IHCP).

How do I get notified when HCPCS E0791 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS E0791. 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 E0791?

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 E0791

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for E0791 in one place.

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