0766T CPT® code: payer coverage and prior authorization6 of 7 payer prior-auth lists that name 0766T require prior authorization or set conditions: HealthSpring, Molina Healthcare of Iowa, Molina Healthcare of Ohio, Molina Healthcare of Texas.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| HealthSpring | Medicare Advantage | All | prior auth required | Aug 1, 2026 | 2026 Q4 Prior Authorization List | |
| Molina Healthcare of Iowa | Medicaid | IA | prior auth required | Jul 1, 2023 | IA Prior Authorization Matrix, effective Q3 2023 | |
| Molina Healthcare of Ohio | Medicaid and MyCare Ohio (MMP) Medicaid | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Ohio | Medicare and MyCare Ohio (MMP) Medicare | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Ohio | Exchange | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Texas | Exchange | TX | prior auth required | PA Modernization - PA requirements will be removed where covered | Jan 1, 2024 | Marketplace Prior Authorization (PA) Code Matrix (Texas), effective July 1, 2026 |
0766T appears in 11 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Rhode Island, Blue Shield of California, BlueCross BlueShield of South Carolina, Capital Blue Cross, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Pulsed Electromagnetic Stimulation (0175) | not covered | Jun 23, 2026 | payer document |
| Anthem | Electrical Stimulation as a Treatment for Pain and Other Conditions: Surface and Percutaneous Devices (DME.00011) | unproven / investigational | Feb 19, 2026 | payer document |
| Blue Cross & Blue Shield of Rhode Island | Transcutaneous Electrical Nerve Stimulation and Transcutaneous Afferent Patterned Stimulation | not covered | Feb 19, 2025 | payer document |
| Blue Shield of California | Transcutaneous Electrical Nerve Stimulation and Transcutaneous Afferent Patterned Stimulation (1.01.09) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Transcutaneous Electrical Nerve Stimulation and Transcutaneous Afferent Patterned Stimulation (CAM 10109) | listed, no stance | Feb 1, 2026 | payer document |
| Capital Blue Cross | Experimental and Investigational Procedures (MP 4.002) Procedure codes: Miscellaneous | listed, no stance | Sep 1, 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 |
| Premera Blue Cross | Electrical Stimulation Devices (1.01.507) | listed, no stance | Feb 10, 2026 | payer document |
| Premera Blue Cross | Non-covered Experimental/Investigational Services Page | 9 of 38 | ∞ | listed, no stance | Oct 1, 2026 | payer document |
| UnitedHealthcare | Omnibus Codes (MMP107.09) primary procedure) | Policy titled | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Omnibus Codes (for Ohio Only) (CS087OH.G) | listed, no stance | Sep 1, 2026 | payer document |
Prior authorization required or conditional in IN.
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.