14060 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 14060

40 of 40 payer prior-auth lists that name 14060 require prior authorization or set conditions: Aetna, Neighborhood Health Partnership, Oxford Health Plans, Rocky Mountain Health Plans, UnitedHealthcare, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
AetnaCommercialAllprior auth under conditionssite of care: outpatient hospitalOct 1, 2026Participating provider precertification list for Aetna®
Neighborhood Health PartnershipNeighborhood Health PartnershipFLprior auth under conditionssite of care: outpatient hospital; not in AK, IL, GU, MA, PR, RI, TX, UT, VI, WISep 1, 2026Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026
Oxford Health PlansOxford Health PlansAllprior auth under conditionssite of care: outpatient hospitalOct 1, 2026Prior Authorization Requirements for Oxford Effective October 1, 2026
Rocky Mountain Health PlansRocky Mountain Health Plans CHP+COprior auth requiredOct 1, 2026Rocky Mountain Children’s Health Plan - prior authorization Effective October 1, 2026
Rocky Mountain Health PlansRocky Mountain Health Plans Prime / RAECOprior auth requiredOct 1, 2026Rocky Mountain Health Plans PRIME Effective October 1, 2026
UnitedHealthcareUnitedHealthcare CommercialAllprior auth under conditionssite of care: outpatient hospital; not in AK, GU, IL, MA, PR, RI, TX, UT, VI, WIOct 1, 2026Prior authorization requirements for UnitedHealthcare commercial plans Effective October 1, 2026
UnitedHealthcareUnitedHealthcare Complete (Individual & Family plans)Allprior auth requiredSep 1, 2026Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026
UnitedHealthcareUnitedHealthcare Individual Exchange plansAllprior auth requiredsite of care: site of service reviewedOct 1, 2026Prior authorization requirements for UnitedHealthcare Individual Exchange plans Effective October 1, 2026
UnitedHealthcareUnitedHealthcare Mid-Atlantic Health PlansAllprior auth under conditionssite of care: outpatient hospital; not in AK, GU, IL, MA, PR, RI, TX, UT, VI, WIOct 1, 2026Prior authorization requirements for UnitedHealthcare Mid-Atlantic Health Plans Effective October 1, 2026
UnitedHealthcareUnitedHealthcare of the River ValleyAllprior auth under conditionssite of care: outpatient hospital; not in AK, IL, MA, PR, RI, TX, UT, VI, WIOct 1, 2026Prior authorization requirements for UnitedHealthcare of the River Valley Effective October 1, 2026
UnitedHealthcare Community PlanAHCCCS Complete Care (ACC)AZprior auth under conditionssite of care: outpatient hospitalOct 1, 2026Prior authorization requirements for AHCCCS Complete Care (ACC) Medicaid effective October 1, 2026
UnitedHealthcare Community PlanALTCS Developmentally DisabledAZprior auth under conditionssite of care: outpatient hospitalOct 1, 2026Prior authorization requirements for Arizona Developmental Disabilities Effective October 1, 2026
UnitedHealthcare Community PlanKanCareKSprior auth requiredOct 1, 2026Prior authorization requirements for Kansas Medicaid Effective October 1, 2026
UnitedHealthcare Community PlanMaryland HealthChoiceMDprior auth under conditionssite of care: outpatient hospitalSep 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Maryland Effective September 1, 2026
UnitedHealthcare Community PlanMichigan Medicaid, Healthy Michigan Plan, CSHCSMIprior auth under conditionssite of care: outpatient hospital, ASCOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Michigan, Healthy Michigan Plan and Children’s Special Health Care Services Effective October 1, 2026
UnitedHealthcare Community PlanMinnesota Metro MedicaidMNprior auth requiredOct 1, 2024Prior authorization requirements for Minnesota Medicaid Effective October 1, 2024
UnitedHealthcare Community PlanMississippi CHIPMSprior auth under conditionssite of care: outpatient hospitalApr 1, 2025Prior authorization requirements for Mississippi Children’s Health Insurance Program Effective Apr. 1, 2025
UnitedHealthcare Community PlanMississippiCANMSprior auth under conditionssite of care: outpatient hospitalApr 1, 2025Prior authorization requirements for UnitedHealthcare Community Plan of Mississippi – Mississippi Coordinated Access Network (MississippiCAN) Effective Apr. 1, 2025
UnitedHealthcare Community PlanMissouri MedicaidMOprior auth under conditionssite of care: outpatient hospitalJul 1, 2026Prior authorization requirements for Missouri Medicaid Effective July 1, 2026
UnitedHealthcare Community PlanNebraska Heritage HealthNEprior auth requiredJul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Nebraska Effective July 1, 2026 General Information This list contains prior authorization requirements for participating United
UnitedHealthcare Community PlanNew Jersey FamilyCareNJprior auth under conditionssite of care: outpatient hospitalOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of New Jersey Effective October 1, 2026 General Information This list contains prior authorization requirements for participating U
UnitedHealthcare Community PlanNorth Carolina MedicaidNCprior auth requiredsite of care: site of service reviewedOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of North Carolina Effective October 1, 2026 July 1, 2024
UnitedHealthcare Community PlanOhio MedicaidOHprior auth under conditionssite of care: outpatient hospital, ASCNov 1, 2025Prior authorization requirements for Ohio Medicaid Effective November 1, 2025 General Information This list contains prior authorization requirements for participating UnitedHealthcare Community Plan
UnitedHealthcare Community PlanPennsylvania CHIPPAprior auth under conditionssite of care: outpatient hospitalJul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Pennsylvania CHIP Effective July 1, 2026
UnitedHealthcare Community PlanPennsylvania MedicaidPAprior auth under conditionssite of care: outpatient hospitalJul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Pennsylvania Effective July 1, 2026
UnitedHealthcare Community PlanRhode Island MedicaidRIprior auth under conditionssite of care: outpatient hospitalMay 1, 2026Prior authorization requirements for Rhode Island Medicaid Effective May 1, 2026 This list contains prior authorization requirements for participating UnitedHealthcare Community Plan of Rhode Island h
UnitedHealthcare Community PlanTennCareTNprior auth under conditionssite of care: outpatient hospitalOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Tennessee Effective October 1, 2026
UnitedHealthcare Community PlanTexas CHIPTXprior auth under conditionssite of care: outpatient hospitalJul 1, 2020Prior authorization requirements for Texas CHIP Effective September 1, 2026 This list contains prior authorization requirements for participating UnitedHealthcare Community Plan Texas CHIP health care
UnitedHealthcare Community PlanTexas STARTXprior auth under conditionssite of care: outpatient hospitalJul 1, 2020Prior authorization requirements for Texas STAR Effective September 1, 2026 This list contains prior authorization review requirements for participating UnitedHealthcare Community Plan of Texas STAR h
UnitedHealthcare Community PlanTexas STAR KidsTXprior auth under conditionssite of care: outpatient hospitalJul 1, 2020Prior authorization requirements for STAR Kids Effective September 1, 2026 This list contains prior authorization review requirements for participating UnitedHealthcare Community Plan of Texas STAR Ki
UnitedHealthcare Community PlanTexas STAR+PLUSTXprior auth under conditionssite of care: outpatient hospitalJul 1, 2020Prior authorization requirements for STAR+Plus Effective September 1, 2026 This list contains prior authorization requirements for participating UnitedHealthcare Community Plan STAR+PLUS health care p
UnitedHealthcare Community PlanUnitedHealthcare Community Plan of FloridaFLprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHeathcare Community Plan of Florida Effective October 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Community Plan of Hawaii (QUEST Integration)HIprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Hawaii Effective October 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Community Plan of KentuckyKYprior auth requiredJul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Kentucky Effective July 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Community Plan of New YorkNYprior auth under conditionssite of care: outpatient hospitalOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of New York Effective October 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Connected (Texas MMP)TXprior auth requiredJul 1, 2021Prior authorization requirements for UnitedHealthcare Connected (Medicare-Medicaid Plan) Texas Effective November 1, 2025 This list contains prior authorization review requirements for participating U
UnitedHealthcare Community PlanVirginia Cardinal Care LTSSVAprior auth requiredOct 1, 2026Prior authorization requirements for Virginia Cardinal Care LTSS Effective October 1, 2026
UnitedHealthcare Community PlanVirginia Cardinal Care MedicaidVAprior auth requiredOct 1, 2026Prior authorization requirements for Virginia Cardinal Care Effective October 1, 2026
UnitedHealthcare Community PlanWashington Apple HealthWAprior auth under conditionssite of care: outpatient hospitalOct 1, 2026Prior authorization requirements for the UnitedHealthcare Community Plan of Washington Effective April 1, 2023
UnitedHealthcare Community PlanWisconsin BadgerCare Plus and Medicaid SSIWIprior auth under conditionsonly with dx F64.0, F64.1, F64.2, F64.8, F64.9, Z87.890Sep 1, 2026Prior authorization requirements for Wisconsin Medicaid Effective September 1, 2026 General Information This list contains prior authorization requirements for participating UnitedHealthcare Community

Payer coverage policies that name 14060

14060 appears in 20 coverage policies from Aetna, Anthem, Capital Blue Cross, Regence, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaHeadaches: Invasive Procedures (0707)not coveredJul 23, 2026payer document
AetnaLymphedema (0069)not covered (range 14000-14350)Feb 25, 2026payer document
AetnaSkin and Soft Tissue Substitutes (0244)not covered (range 10040-19499)Jul 29, 2026payer document
AnthemSurgical and Ablative Treatments for Chronic Headaches (SURG.00096)unproven / investigational (range 14060-14061)Feb 19, 2026payer document
AnthemTreatment of Keloids and Scar Revision (CG-SURG-31)covered if criteria are met (range 14000-14302)May 14, 2026payer document
Capital Blue CrossGender Affirming Surgery (MP 1.144)
Procedure codes		covered if criteria are metApr 1, 2026payer document
RegenceSurgical Site of Care – Hospital Outpatient (Utilization Management 19)listed, no stanceMay 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (CS027.AD)listed, no stanceJul 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (MP.007.33)listed, no stanceJun 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (MMP022.16)
Adjacent Tissue Transfer		listed, no stanceSep 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (for Idaho Only) (CS027ID.C)
The following codes may be Cosmetic; review is required to determine if considered Cosmetic or		listed, no stanceMay 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (for Kansas Only) (CS027KS.03)listed, no stanceSep 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (for Kentucky Only) (CS027KY.13)listed, no stanceAug 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (for Nebraska Only) (CS027NE.U)listed, no stanceJul 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (for New Jersey Only) (CS027NJ.W)listed, no stanceJul 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (for New Mexico Only) (CS027NM.E)listed, no stanceJul 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (for North Carolina Only) (CSNC.MP.007.10)listed, no stanceJul 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (for Ohio Only) (CS027OH.E)listed, no stanceAug 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (for Pennsylvania Only) (CS027PA.AD)listed, no stanceJul 1, 2026payer document
UnitedHealthcareCosmetic and Reconstructive Procedures (for Tennessee Only) (CS027TN.AB)listed, no stanceAug 1, 2026payer document

Recent prior-auth changes

  • Oct 1, 2026: conditions changed, UnitedHealthcare Community Plan
  • Oct 1, 2026: conditions changed, UnitedHealthcare Community Plan
  • Oct 1, 2026: conditions changed, UnitedHealthcare Community Plan
  • Jul 1, 2026: conditions changed, Neighborhood Health Partnership
  • Jul 1, 2026: conditions changed, UnitedHealthcare
  • Jul 1, 2026: conditions changed, UnitedHealthcare Community Plan
  • Jul 1, 2026: conditions changed, UnitedHealthcare
  • Jul 1, 2026: conditions changed, UnitedHealthcare
  • Mar 1, 2026: conditions changed, UnitedHealthcare
  • Feb 1, 2026: conditions changed, UnitedHealthcare Community Plan

Medicaid fee-for-service

Prior authorization required or conditional in VA, WV.

  • AZ: $662.63 (asc), effective Oct 1, 2026
  • CO: $551.28 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $462.34 (physician, facility), effective Jan 1, 2026
  • IL: $447.90 (practitioner), effective Apr 1, 2024
  • IN: $516.38 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $300.00 (asc, facility), effective Aug 1, 1982
  • KY: $1101.65 (asc), effective Jan 1, 2026
  • LA: $611.65 (professional), effective Jul 1, 2025
  • MA: $696.96 (asc), effective May 1, 2026
  • MS: $784.87 (comprehensive, facility), effective Oct 1, 2025
  • ND: $649.43 (physician, facility), effective Aug 1, 2026
  • NE: $413.00 (asc), effective Jul 1, 2024
  • NY: $320.12 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $340.75 (physician, facility), effective Jan 1, 2024
  • OK: $1005.06 (asc), effective Jan 1, 2026
  • TX: $709.01 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $496.82 (medical, facility), effective Jul 1, 2026
  • VT: $1602.06 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $912.46 (outpatient_hospital_apc, Ambulatory Surgical Centers), 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.