0780T CPT® code: payer coverage and prior authorization1 of 1 payer prior-auth lists that name 0780T require prior authorization or set conditions: HealthSpring.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| HealthSpring | Medicare Advantage | All | prior auth required | Aug 1, 2026 | 2026 Q4 Prior Authorization List |
0780T appears in 9 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Alzheimer's Disease: Experimental, Investigational, or Unproven Treatments (0788) | not covered | Nov 19, 2025 | payer document |
| Aetna | Eating Disorders (0511) | not covered | Aug 4, 2026 | payer document |
| Aetna | Fecal Bacteriotherapy (0844) | covered if criteria are met | Mar 25, 2026 | payer document |
| Aetna | Obstructive Sleep Apnea in Adults (0004) | listed, no stance | Oct 6, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Fecal Microbiota Transplantation | listed, no stance | payer document | |
| Blue Cross Blue Shield of Massachusetts | Fecal Micobiota Transplantation (682) | listed, no stance | 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) | Fecal Microbiota Transplantation (FMT) (SUR703.049) | listed, no stance | Jun 15, 2025 | payer document |
| Premera Blue Cross | Pharmacologic Treatment of Clostridioides Difficile | listed, no stance | Mar 10, 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.