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PAYER POLICY CHANGES

E1031 Insurance Policy Changes

HCPCS E1031 is officially defined as "Rollabout chair, any and all types with casters 5" or greater." HCPCS E1031 is referenced in 6 tracked payer policy changes from BlueCross BlueShield of South Carolina, Excellus BlueCross BlueShield, and 3 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS E1031 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 rules9
Payers requiring prior auth9
  • 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

    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 Ambetter require prior authorization for E1031?

Ambetter lists E1031 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 E1031?

AmeriHealth Caritas lists E1031 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans, with conditions. Verify with the payer before scheduling.

Does BCBS Michigan require prior authorization for E1031?

BCBS Michigan lists E1031 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 E1031?

CalViva Health lists E1031 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 E1031?

Colorado Medicaid lists E1031 on Colorado Health First Colorado Fee Schedule (Prior Authorization Needed column) for medicaid ffs plans (list dated July 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS E1031?

There are 6 tracked policy changes affecting HCPCS E1031, including updates from BlueCross BlueShield of South Carolina, Excellus BlueCross BlueShield, Indiana Medicaid (IHCP). Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS E1031?

Payers that have issued tracked updates for HCPCS E1031 include: BlueCross BlueShield of South Carolina, Excellus BlueCross BlueShield, Indiana Medicaid (IHCP), Aetna, Premera Blue Cross.

How do I get notified when HCPCS E1031 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS E1031. 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 E1031?

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 E1031

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for E1031 in one place.

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RELATED

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