0743T CPT® code: payer coverage and prior authorization3 of 3 payer prior-auth lists that name 0743T require prior authorization or set conditions: HealthSpring, Oxford Health Plans, UnitedHealthcare.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| HealthSpring | Medicare Advantage | All | prior auth required | Aug 1, 2026 | 2026 Q4 Prior Authorization List | |
| Oxford Health Plans | Oxford Health Plans | All | prior auth required | Oct 1, 2026 | Prior Authorization Requirements for Oxford Effective October 1, 2026 | |
| UnitedHealthcare | UnitedHealthcare West commercial plans | All | prior auth required | Oct 1, 2026 | Prior authorization requirements for UnitedHealthcare West commercial plans Effective October 1, 2026 |
0743T appears in 12 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, BlueCross BlueShield of South Carolina, Capital Blue Cross, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Bone Mass Measurements (0134) | not covered | Mar 19, 2026 | payer document |
| Anthem | Bone Mineral Density Testing Measurement (CG-RAD-32) | not covered | Aug 13, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Vertebral Fracture Assessment With Densitometry Or Biomechanical Computed Tomography | unproven / investigational | payer document | |
| BlueCross BlueShield of South Carolina | Dynamic Spinal Visualization and Vertebral Motion Analysis (CAM 60146) | listed, no stance | Feb 1, 2026 | payer document |
| Capital Blue Cross | Experimental and Investigational Procedures (MP 4.002) Procedure codes: Musculoskeletal | listed, no stance | Sep 1, 2026 | payer document |
| Capital Blue Cross | Vertebral Fracture Assessment and Biomechanical Computed Tomography (MP 5.046) Procedure codes | unproven / investigational | Apr 1, 2026 | payer document |
| Cigna | Bone Mineral Density Measurement (0300) | not covered | Apr 15, 2026 | payer 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 stance | Jan 1, 2027 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Dynamic Spinal Visualization and Vertebral Motion Analysis (RAD601.046) | listed, no stance | Jan 1, 2026 | payer document |
| Premera Blue Cross | Non-covered Experimental/Investigational Services Page | 8 of 38 | ∞ | listed, no stance | Oct 1, 2026 | payer document |
| Regence | New and Emerging Medical Technologies and Procedures (Medicine 149) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Category III Codes (2026T0644Q) | listed, no stance | Jul 1, 2026 | payer document |
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.