17003 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 17003

Payer coverage policies that name 17003

17003 appears in 16 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Capital Blue Cross, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).

PayerPolicyRole in policyReviewedDocument
AetnaActinic Keratoses Treatments (0567)covered if criteria are metAug 21, 2026payer document
AetnaBenign Skin Lesion Removal (0633)covered if criteria are met (range 17000-17004)Sep 9, 2026payer document
AetnaCarbon Dioxide Laser (0427)covered if criteria are met (range 17000-17004)Jul 8, 2026payer document
AetnaCryoablation (0100)listed, no stance (range 17000-17286)Aug 4, 2026payer document
AetnaDermabrasion, Chemical Peels, and Acne Surgery (0251)listed, no stance (range 17000-17250)Apr 15, 2026payer document
AetnaLaser Treatment for Psoriasis and Other Selected Skin Conditions (0577)not covered (range 17000-17004)Jul 15, 2026payer document
AetnaPulsed Dye Laser Treatment (0559)covered if criteria are metSep 18, 2026payer document
AetnaRosacea (0547)not coveredAug 21, 2026payer document
AetnaSkin and Soft Tissue Substitutes (0244)not covered (range 10040-19499)Jul 29, 2026payer document
AnthemDestruction of Pre-Malignant Skin Lesions (CG-SURG-37)covered if criteria are metAug 13, 2026payer document
Blue Cross & Blue Shield of MississippiNonpharmacologic Treatment Of Rosaceaunproven / investigationalpayer document
Blue Cross & Blue Shield of MississippiRemoval Of Benign Skin Lesions And Scars (L.7.01.412)covered if criteria are metpayer document
Blue Cross Blue Shield of MassachusettsBenign Skin Lesions (707)listed, no stancepayer document
Blue Cross Blue Shield of MassachusettsNonpharmacologic Treatment of Rosacea (462)unproven / investigationalpayer document
Capital Blue CrossCosmetic and Reconstructive Surgery (MP 1.004)
Procedure codes
covered if criteria are metSep 1, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Nonpharmacologic Treatment of Rosacea (THE801.030)
CPT Codes 15260, 15261, 15780, 15781, 15782, 15783, 15788, 15789, 15792,
listed, no stanceMay 1, 2026payer document

Medicaid fee-for-service

  • AZ: $4.88 (outpatient_hospital, RF133), effective Oct 1, 2025
  • CO: $5.63 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $6.80 (pediatric_surgery, pediatric surgeon), effective Jan 1, 2025
  • IL: $1.86 (practitioner), effective Apr 1, 2024
  • IN: $1.61 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $22.00 (asc, facility), effective Mar 4, 2005
  • KY: $0.00 (asc), effective Jan 1, 2026
  • LA: $5.45 (professional), effective Feb 1, 2013
  • MA: $0.00 (asc), effective May 1, 2026
  • MS: $1.46 (comprehensive), effective Jul 1, 2026
  • ND: $7.13 (physician), effective Aug 1, 2026
  • NE: $9.24 (physician, facility), effective Jul 1, 2026
  • NY: $3.84 (nurse_practitioner, facility), effective Jul 1, 2026
  • OH: $2.08 (physician, facility), effective Jan 1, 2024
  • OK: $1.53 (physician, facility), effective Jul 1, 2026
  • TX: $1.55 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2021
  • VA: $1.45 (medical, facility), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $0.96 (physician, facility), effective Jul 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.