0723T CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0723T

4 of 4 payer prior-auth lists that name 0723T require prior authorization or set conditions: Blue Shield of California Promise Health Plan, HealthSpring, Oxford Health Plans, UnitedHealthcare.

PayerPlanStatePrior authConditionsSinceSource
Blue Shield of California Promise Health PlanPromise Health Plan Medi-CalCAprior auth requiredSep 1, 2026Medi-Cal Prior Authorization List
HealthSpringMedicare AdvantageAllprior auth requiredAug 1, 20262026 Q4 Prior Authorization List
Oxford Health PlansOxford Health PlansAllprior auth requiredOct 1, 2026Prior Authorization Requirements for Oxford Effective October 1, 2026
UnitedHealthcareUnitedHealthcare West commercial plansAllprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHealthcare West commercial plans Effective October 1, 2026

Payer coverage policies that name 0723T

0723T appears in 7 coverage policies from Aetna, Capital Blue Cross, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaMagnetic Resonance Cholangiopancreatography (0384)not coveredJun 25, 2026payer document
AetnaNoninvasive Tests for Hepatic Fibrosis (0690)not coveredJun 18, 2026payer document
Capital Blue CrossExperimental and Investigational Procedures (MP 4.002)
Procedure codes: Radiology
listed, no stanceSep 1, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Category III Current Procedural Terminology (CPT®) Codes
CPT Codes 0054T, 0055T, 0071T, 0072T, 0075T, 0076T, 0095T, 0098T, 0100T, 0101T,
listed, no stanceJan 1, 2027payer document
Premera Blue CrossNon-covered Experimental/Investigational Services
Page | 8 of 38 | ∞
listed, no stanceOct 1, 2026payer document
RegenceNew and Emerging Medical Technologies and Procedures (Medicine 149)
with automated analysis and | (Acarix)
listed, no stanceJun 1, 2026payer document
UnitedHealthcareCategory III Codes (2026T0644Q)listed, no stanceJul 1, 2026payer document

Recent prior-auth changes

  • Aug 1, 2026: PA added, HealthSpring
  • Apr 1, 2023: PA added, Blue Shield of California Promise Health Plan

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • KS: $228.33 (default, Exempt Physician), effective Jul 1, 2022
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

From payers' published prior-auth lists, coverage policies and state Medicaid fee schedules, updated Oct 16, 2026. The role is what the policy's own code table or text says about the code. Not a guarantee of coverage or payment; verify with the payer. CPT® is a registered trademark of the American Medical Association.