17313 CPT® code: payer coverage and prior authorization2 of 2 payer prior-auth lists that name 17313 require prior authorization or set conditions: Neighborhood Health Partnership, UnitedHealthcare.
| 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 |
17313 appears in 5 coverage policies from Aetna, Anthem, Regence.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Mohs Micrographic Surgery (0383) | covered if criteria are met | May 28, 2026 | payer document |
| Aetna | Skin and Soft Tissue Substitutes (0244) | listed, no stance (range 17311-17315) | Jul 29, 2026 | payer document |
| Aetna | Skin and Soft Tissue Substitutes (0244) | not covered (range 10040-19499) | Jul 29, 2026 | payer document |
| Aetna | Total Body Photography, Dermoscopy and Other Selected Noninvasive Dermatologic Tests (0188) | listed, no stance (range 17311-17315) | Aug 4, 2026 | payer document |
| Anthem | Mohs Micrographic Surgery (CG-SURG-90) | covered if criteria are met (range 17313-17314) | Feb 19, 2026 | payer document |
| Regence | Surgical Site of Care – Hospital Outpatient (Utilization Management 19) | listed, no stance | May 1, 2026 | payer document |
Prior authorization required or conditional in WV.
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.