1045T CPT® code: payer coverage and prior authorization1 of 1 payer prior-auth lists that name 1045T require prior authorization or set conditions: HealthSpring.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| HealthSpring | Medicare Advantage | All | prior auth required | Aug 1, 2026 | 2026 Q4 Prior Authorization List |
1045T appears in 10 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Skin and Soft Tissue Substitutes (0244) CPT not covered for indications listed in the CPB | covered if criteria are met | Jul 29, 2026 | payer document |
| Aetna | Skin and Soft Tissue Substitutes (0244) | not covered (range 10040-19499) | Jul 29, 2026 | payer document |
| Anthem | Products for Wound Healing and Soft Tissue Grafting: Investigational (SURG.00011) | unproven / investigational | Aug 13, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Bioengineered Skin And Soft Tissue Substitutes (A.7.01.113) | unproven / investigational | payer document | |
| Blue Cross Blue Shield of Massachusetts | Bioengineered Skin and Soft Tissue Substitutes (663) Procedure | unproven / investigational | payer document | |
| Blue Cross NC | Skin and Soft Tissue Substitutes | listed, no stance | Aug 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Bioengineered Skin and Soft Tissue Substitutes (SUR704.012) CPT Codes 15011, 15012, 15013, 15014, 15015, 15016, 15017, 15018, 15271, 15272, | listed, no stance | Jul 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 | Bioengineered Skin and Soft Tissue Substitutes (7.01.582) Page | 11 of 41 | ∞ | unproven / investigational | Oct 1, 2026 | payer document |
| Regence | Bioengineered Skin and Soft Tissue Substitutes and Amniotic Products (Medicine 170) | 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 OH.
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.