0954T CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0954T

2 of 2 payer prior-auth lists that name 0954T require prior authorization or set conditions: Blue Shield of California Promise Health Plan, HealthSpring.

PayerPlanStatePrior authConditionsSinceSource
Blue Shield of California Promise Health PlanPromise Health Plan Medi-CalCAprior auth requiredSep 1, 2026Medi-Cal Prior Authorization List
HealthSpringMedicare AdvantageAllprior auth requiredAug 1, 20262026 Q4 Prior Authorization List

Payer coverage policies that name 0954T

0954T appears in 21 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Rhode Island, 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
AetnaHearing Aids (0612)listed, no stanceSep 23, 2026payer document
AnthemImplantable Middle Ear Hearing Aids (SURG.00084)unproven / investigationalMay 14, 2026payer document
Blue Cross & Blue Shield of Rhode IslandSemi-Implantable and Fully-Implantable Middle Ear Hearing Aids sanot coveredApr 1, 2026payer document
Blue Cross NCSemi-Implantable and Fully Implantable Middle Ear Hearing Aidlisted, no stanceFeb 1, 2026payer document
Blue Shield of CaliforniaSemi-Implantable and Fully Implantable Middle Ear Hearing Aids (7.01.84)listed, no stancepayer document
Capital Blue CrossExperimental and Investigational Procedures (MP 4.002)
Procedure codes: Face, head, neck		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 CrossSemi-Implantable and Fully Implantable Middle Ear Hearing Aids (7.01.84)listed, no stanceApr 13, 2026payer document
RegenceNew and Emerging Medical Technologies and Procedures (Medicine 149)
hearing implant; initial placement, | Implant system		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Kansas Only) (CS052KS.04)
Totally Implantable Active Middle Ear Hearing Implant		listed, no stanceSep 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Nebraska Only) (CS052NE.V)
Totally Implantable Active Middle Ear Hearing Implant		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Tennessee Only) (CS052TN.T)
Totally Implantable Active Middle Ear Hearing Implant		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (2026T0396II)
Totally Implantable Active Middle Ear Hearing Implant		listed, no stanceMar 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (CS052.V)
Totally Implantable Active Middle Ear Hearing Implants		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Idaho Only) (CS052ID.D)
Totally Implantable Active Middle Ear Hearing Implant		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Louisiana Only) (CS052LA.O)
Totally Implantable Active Middle Ear Hearing Implant		listed, no stanceAug 1, 2025payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for New Mexico Only) (CS052NM.D)
Totally Implantable Active Middle Ear Hearing Implant		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for North Carolina Only) (CSNCT0396.10)
Totally Implantable Active Middle Ear Hearing Implant		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Ohio Only) (CS052OH.F)
Totally Implantable Active Middle Ear Hearing Implant		listed, no stanceSep 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Pennsylvania Only) (CS052PA.S)
Totally Implantable Active Middle Ear Hearing Implant		listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Instruments and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Kentucky Only) (CS052KY.13)
Totally Implantable Active Middle Ear Hearing Implant		listed, no stanceAug 1, 2026payer document

Recent prior-auth changes

  • Aug 1, 2026: PA added, HealthSpring
  • Sep 1, 2025: PA added, Blue Shield of California Promise Health Plan

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.