0741T CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0741T

8 of 9 payer prior-auth lists that name 0741T require prior authorization or set conditions: HealthSpring, Molina Healthcare of Iowa, Molina Healthcare of Ohio, Molina Healthcare of Texas, Oxford Health Plans, UnitedHealthcare.

PayerPlanStatePrior authConditionsSinceSource
HealthSpringMedicare AdvantageAllprior auth requiredAug 1, 20262026 Q4 Prior Authorization List
Molina Healthcare of IowaMedicaidIAprior auth requiredJul 1, 2023IA Prior Authorization Matrix, effective Q3 2023
Molina Healthcare of OhioMedicaid and MyCare Ohio (MMP) MedicaidOHprior auth requiredOct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of OhioMedicare and MyCare Ohio (MMP) MedicareOHprior auth requiredOct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of OhioExchangeOHprior auth requiredOct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of TexasExchangeTXprior auth requiredPA Modernization - PA requirements will be removed where coveredJan 1, 2024Marketplace Prior Authorization (PA) Code Matrix (Texas), effective July 1, 2026
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 0741T

0741T appears in 6 coverage policies from Aetna, Blue Cross Blue Shield of Massachusetts, Capital Blue Cross, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaDiabetes Tests, Programs and Supplies (0070)not coveredFeb 20, 2026payer document
Blue Cross Blue Shield of MassachusettsInsulin Delivery Devices (332)unproven / investigationalpayer document
Capital Blue CrossExperimental and Investigational Procedures (MP 4.002)
Procedure codes: Miscellaneous
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 CrossPrescription Digital Therapeutics (3.03.500)unproven / investigationalAug 11, 2026payer document
UnitedHealthcareCategory III Codes (2026T0644Q)listed, no stanceJul 1, 2026payer document

Recent prior-auth changes

  • Aug 1, 2026: PA added, HealthSpring
  • Jan 1, 2025: PA removed, Molina Healthcare of Texas
  • Jan 1, 2023: PA added, Molina Healthcare of Texas
  • Jan 1, 2023: PA added, Molina Healthcare of Ohio

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • 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.