13151 CPT® code: payer coverage and prior authorization
Payer policies and prior authorization for 13151
3 of 3 payer prior-auth lists that name 13151 require prior authorization or set conditions: Neighborhood Health Partnership, UnitedHealthcare, UnitedHealthcare Community Plan.
Payer
Plan
State
Prior auth
Conditions
Since
Source
Neighborhood Health Partnership
Neighborhood Health Partnership
FL
prior auth under conditions
site of care: outpatient hospital; not in AK, IL, GU, MA, PR, RI, TX, UT, VI, WI
OH: $140.68 (physician, facility), effective Jan 1, 2024
OK: $360.62 (asc), effective Jan 1, 2026
TX: $216.80 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
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.