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PAYER POLICY CHANGES

Q4106 Insurance Policy Changes

HCPCS Q4106 is officially defined as "Dermagraft, per square centimeter." HCPCS Q4106 is referenced in 10 tracked payer policy changes from Arkansas Blue Cross Blue Shield, Excellus BlueCross BlueShield, and 4 other payers. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS Q4106 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

Watch Q4106

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REFERENCE DATA

Payers with rules12
Payers requiring prior auth12
  • Cigna · Effective August 1, 2026

    Prior authorization required

    HealthSpring Prior Authorization Procedure Code List

  • CountyCare Health Plan · Effective April 23, 2026

    Prior authorization required

    CountyCare Prior Authorization Look-Up Tool (All Codes)

  • BCBS Illinois · Effective January 1, 2026

    Prior authorization required

    Utilization Management Process

FREQUENTLY ASKED QUESTIONS

Does Ambetter require prior authorization for Q4106?

Ambetter lists Q4106 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 Q4106?

AmeriHealth Caritas lists Q4106 on AmeriHealth Caritas Louisiana prior authorization service list for medicaid managed plans, with conditions. Verify with the payer before scheduling.

Does Arizona Complete Health require prior authorization for Q4106?

Arizona Complete Health lists Q4106 on Arizona Complete Health CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

Does BCBS Illinois require prior authorization for Q4106?

BCBS Illinois lists Q4106 on Blue Cross Community Health Plans (Illinois Medicaid) Prior Authorization Code List for medicaid managed plans, with conditions (list dated October 1, 2026). Verify with the payer before scheduling.

Does BCBS New Mexico require prior authorization for Q4106?

BCBS New Mexico lists Q4106 on Medicare Advantage Prior Authorization Procedure Code List for medicare advantage plans (list dated October 1, 2026). Verify with the payer before scheduling.

What insurance policy changes affect HCPCS Q4106?

There are 10 tracked policy changes affecting HCPCS Q4106, including updates from Arkansas Blue Cross Blue Shield, Excellus BlueCross BlueShield, Humana. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for HCPCS Q4106?

Payers that have issued tracked updates for HCPCS Q4106 include: Arkansas Blue Cross Blue Shield, Excellus BlueCross BlueShield, Humana, Medical Mutual of Ohio, Health Net, Blue Cross & Blue Shield of Mississippi.

How do I get notified when HCPCS Q4106 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to HCPCS Q4106. 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 Q4106?

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 Q4106

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for Q4106 in one place.

See every payer rule

RELATED

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