0935T CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0935T

9 of 9 payer prior-auth lists that name 0935T require prior authorization or set conditions: CarePlus Health Plans, Humana.

PayerPlanStatePrior authConditionsSinceSource
CarePlus Health PlansCarePlus Health PlansFLprior auth requiredJan 1, 2027Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List
HumanaHumana D-SNP (FL)FLprior auth requiredJan 1, 20271 *New prior authorization requirement 787403FL0725 FLHMQSREN Humana Dual Fully Integrated Florida Prior Authorization and Notification List
HumanaHumana D-SNP (IL)ILprior auth requiredJan 1, 2027Humana Dual Fully Integrated Illinois Prior Authorization and Notification List
HumanaHumana D-SNP (IN)INprior auth requiredJan 1, 2027*New prior authorization requirement 814403IN0825 H4939_INHN6Z6EN_C Humana PathWays Dual Care (HMO-POS D-SNP) Indiana Prior Authorization and Notification List
HumanaHumana D-SNP (MI)MIprior auth requiredJan 1, 20271 Humana Dual Highly Integrated Michigan Prior Authorization and Notification List
HumanaHumana D-SNP (SC)SCprior auth requiredJan 1, 2027Humana Dual Highly Integrated South Carolina Prior Authorization and Notification List
HumanaHumana D-SNP (VA)VAprior auth requiredJan 1, 2027Virginia Prior Authorization and Notification List
HumanaHumana MA and D-SNPAllprior auth requiredJan 1, 2027Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List
HumanaHumana Puerto Rico MA and Dual Medicare-MedicaidPRprior auth requiredNov 3, 2025Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification

Payer coverage policies that name 0935T

0935T appears in 10 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, 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.

PayerPolicyRole in policyReviewedDocument
AetnaRenal Sympathetic Nerve Ablation (0847)not coveredDec 18, 2025payer document
AnthemRenal Denervation for Hypertension (SURG.00135)unproven / investigationalFeb 19, 2026payer document
Blue Cross & Blue Shield of MississippiRenal Denervation For Uncontrolled Hypertension (A.7.01.136)listed, no stancepayer document
Blue Cross NCRenal Denervation as a Treatment of Hypertensionlisted, no stanceFeb 1, 2026payer document
Blue Shield of CaliforniaRenal Denervation for Uncontrolled Hypertension (7.01.136)listed, no stancepayer document
Capital Blue CrossExperimental and Investigational Procedures (MP 4.002)
Procedure codes: Genitourinary
listed, no stanceSep 1, 2026payer 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 stanceJan 1, 2027payer document
Premera Blue CrossNon-covered Experimental/Investigational Services
Page | 16 of 38 | ∞
listed, no stanceOct 1, 2026payer document
RegenceRadiofrequency and Ultrasound Ablation of the Renal Sympathetic Nerves as a Treatment for Uncontrolled Hypertension (Surgery 235)listed, no stanceAug 1, 2025payer document
UnitedHealthcareCategory III Codes (2026T0644Q)listed, no stanceJul 1, 2026payer 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.