0980T CPT® code: payer coverage and prior authorization6 of 6 payer prior-auth lists that name 0980T require prior authorization or set conditions: Cigna, HealthSpring.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Cigna | ACA/IFP | All | prior auth required | May be delegated to eviCore for some clients | Jul 1, 2025 | Master Precertification List (For Health Care Providers) |
| Cigna | Basic Standard | All | prior auth required | May be delegated to eviCore for some clients | Jul 1, 2025 | Master Precertification List (For Health Care Providers) |
| Cigna | Complete/PHS+/Preferred | All | prior auth required | May be delegated to eviCore for some clients | Jul 1, 2025 | Master Precertification List (For Health Care Providers) |
| Cigna | Other Services | All | prior auth required | Experimental/investigational | Mar 7, 2026 | Cigna Commercial Prior Authorization Procedure Code List: Other Services |
| Cigna | Other Services | All | prior auth required | Experimental/investigational | Mar 7, 2026 | Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs |
| HealthSpring | Medicare Advantage | All | prior auth required | Aug 1, 2026 | 2026 Q4 Prior Authorization List |
0980T appears in 11 coverage policies from Aetna, Anthem, Blue Cross Blue Shield of Massachusetts, Blue Shield of California, Capital Blue Cross, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Cryoanalgesia and Therapeutic Cold (0297) Prophylactic hypothermia, therapeutic hypothermia | not covered | Apr 14, 2026 | payer document |
| Anthem | Oral, Pharyngeal and Maxillofacial Surgical Treatment for Obstructive Sleep Apnea or Snoring (SURG.00129) | unproven / investigational | Aug 13, 2026 | payer document |
| Blue Cross Blue Shield of Massachusetts | Surgical treatment of Snoring and Obstructive Sleep Apnea Syndrome (130) | unproven / investigational | payer document | |
| Blue Shield of California | Surgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome (7.01.101) | listed, no stance | payer document | |
| Capital Blue Cross | Experimental and Investigational Procedures (MP 4.002) Procedure codes: Face, head, neck | listed, no stance | Sep 1, 2026 | payer document |
| Cigna | Category III Current Procedural Terminology (CPT®) codes (0558) | unproven / investigational | Sep 15, 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 | Non-covered Experimental/Investigational Services Page | 19 of 38 | ∞ | listed, no stance | Oct 1, 2026 | payer document |
| Premera Blue Cross | Surgical Treatment of Snoring and Obstructive Sleep Apnea Syndrome (7.01.554) | listed, no stance | Jul 27, 2026 | payer document |
| Regence | New and Emerging Medical Technologies and Procedures (Medicine 149) acoustic and electrocardiogram | technology | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Category III Codes (2026T0644Q) | listed, no stance | Jul 1, 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.