17110 CPT® code: payer coverage and prior authorization3 of 3 payer prior-auth lists that name 17110 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 | Sep 1, 2026 | Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026 |
| UnitedHealthcare | UnitedHealthcare Complete (Individual & Family plans) | All | prior auth under conditions | site of care: outpatient hospital | Sep 1, 2026 | Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026 |
| UnitedHealthcare Community Plan | Maryland HealthChoice | MD | prior auth under conditions | only with dx F64.0, F64.1, F64.2, F64.8, F64.9, Z87.890 | Sep 1, 2026 | Prior authorization requirements for UnitedHealthcare Community Plan of Maryland Effective September 1, 2026 |
17110 appears in 25 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Shield of California, Capital Blue Cross, Centene, Regence.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Benign Skin Lesion Removal (0633) | covered if criteria are met (range 17110-17111) | Sep 9, 2026 | payer document |
| Aetna | Cantharidin (Ycanth) (1051) | listed, no stance | Dec 23, 2025 | payer document |
| Aetna | Carbon Dioxide Laser (0427) | covered if criteria are met | Jul 8, 2026 | payer document |
| Aetna | Cosmetic Surgery and Procedures (0031) Thermal therapy (e.g., radiofrequency (ThermiVa and Viveve procedures) and laser), Laviv (azficel-T) | not covered | Jun 25, 2026 | payer document |
| Aetna | Cryoablation (0100) | listed, no stance (range 17000-17286) | Aug 4, 2026 | payer document |
| Aetna | Dermabrasion, Chemical Peels, and Acne Surgery (0251) | listed, no stance (range 17000-17250) | Apr 15, 2026 | payer document |
| Aetna | Female Sexual Dysfunction (FSD) (0574) | not covered | Sep 10, 2026 | payer document |
| Aetna | Hyperhidrosis (0504) | not covered (range 17110-17111) | Aug 11, 2026 | payer document |
| Aetna | Hypertrophic Scars and Keloids (0389) | covered if criteria are met | May 28, 2026 | payer document |
| Aetna | Laser Treatment for Psoriasis and Other Selected Skin Conditions (0577) | covered if criteria are met (range 17110-17111) | Jul 15, 2026 | payer document |
| Aetna | Lymphangioma and Infantile Hemangioma (0817) | covered if criteria are met (range 17110-17111) | Dec 3, 2025 | payer document |
| Aetna | Phototherapy for Acne (0656) | not covered | Sep 15, 2026 | payer document |
| Aetna | Pulsed Dye Laser Treatment (0559) | covered if criteria are met | Sep 18, 2026 | payer document |
| Aetna | Rosacea (0547) | not covered | Aug 21, 2026 | payer document |
| Aetna | Routine Foot Care (0046) | listed, no stance (range 17110-17111) | Apr 7, 2026 | payer document |
| Aetna | Skin and Soft Tissue Substitutes (0244) | not covered (range 10040-19499) | Jul 29, 2026 | payer document |
| Aetna | YAG Laser in Ophthalmology and Other Selected Indications (0354) | not covered (range 17110-17111) | May 21, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Removal Of Benign Skin Lesions And Scars (L.7.01.412) | covered if criteria are met | payer document | |
| Blue Cross Blue Shield of Massachusetts | Benign Skin Lesions (707) | covered if criteria are met | payer document | |
| Blue Cross Blue Shield of Massachusetts | Laser Treatment of Active Acne (461) | unproven / investigational | payer document | |
| Blue Shield of California | BSC7.08 | Cosmetic and Reconstructive Procedures | listed, no stance | payer document | |
| Blue Shield of California | | Nonpharmacologic Treatment of Rosacea (2.01.71) | listed, no stance | payer document | |
| Capital Blue Cross | Cosmetic and Reconstructive Surgery (MP 1.004) Procedure codes | covered if criteria are met | Sep 1, 2026 | payer document |
| Centene | Cosmetic and Reconstructive Procedures Reference Number: CP.MP.31 (CP.MP.31) | covered if criteria are met | Aug 1, 2026 | payer document |
| Regence | Surgical Site of Care – Hospital Outpatient (Utilization Management 19) | listed, no stance | May 1, 2026 | payer document |
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.