0891T CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0891T

5 of 5 payer prior-auth lists that name 0891T require prior authorization or set conditions: Blue Shield of California, Cigna, HealthSpring.

Payer coverage policies that name 0891T

0891T appears in 22 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Blue Shield of California, Capital Blue Cross, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence, UnitedHealthcare.

Recent prior-auth changes

• Aug 1, 2026: PA added, HealthSpring

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.