`0821T` CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0821T

Payer coverage policies that name 0821T

0821T appears in 3 coverage policies from Aetna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Complementary and Alternative Medicine (0388)	not covered	Jun 25, 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	Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders (5.01.586)	listed, no stance	Jun 9, 2026	payer document

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.

0821T CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0821T

Payer coverage policies that name 0821T

Medicaid fee-for-service

`0821T` CPT® code: payer coverage and prior authorization