`0997T` CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0997T

3 of 3 payer prior-auth lists that name 0997T require prior authorization or set conditions: Cigna.

Payer	Plan	State	Prior auth	Since	Source
Cigna	ACA/IFP	All	prior auth required	Jan 1, 2026	Master Precertification List (For Health Care Providers)
Cigna	Basic Standard	All	prior auth required	Jan 1, 2026	Master Precertification List (For Health Care Providers)
Cigna	Complete/PHS+/Preferred	All	prior auth required	Jan 1, 2026	Master Precertification List (For Health Care Providers)

Payer coverage policies that name 0997T

0997T appears in 8 coverage policies from Aetna, 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.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Transcranial Magnetic Stimulation and Cranial Electrical Stimulation (0469)	not covered	Jul 17, 2026	payer document
Blue Cross NC	Transcranial Magnetic Stimulation as a Treatment of Depression and Other Psychiatric/Neurologic Disorders	listed, no stance	Jun 1, 2026	payer document
Blue Shield of California	BSC9.01 \| Investigational Services	listed, no stance		payer document
Capital Blue Cross	Experimental and Investigational Procedures (MP 4.002) Procedure codes: Radiology	listed, no stance	Sep 1, 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 \| 20 of 38 \| ∞	listed, no stance	Oct 1, 2026	payer document
Regence	Transcranial Magnetic Stimulation as a Treatment of Depression and Other Disorders (Medicine 148)	listed, no stance	Apr 1, 2026	payer document
UnitedHealthcare	Category III Codes (2026T0644Q)	listed, no stance	Jul 1, 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.

0997T CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0997T

Payer coverage policies that name 0997T

Medicaid fee-for-service

`0997T` CPT® code: payer coverage and prior authorization