Payer policies › CPT 1900019000 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 19000 2 of 2 payer prior-auth lists that name 19000 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, ASC; 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, ASC Sep 1, 2026 Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026
Payer coverage policies that name 19000 19000 appears in 3 coverage policies from Aetna, UnitedHealthcare.
Payer Policy Role in policy Reviewed Document Aetna Skin and Soft Tissue Substitutes (0244) not covered (range 10040-19499) Jul 29, 2026 payer document Aetna Ultrasound Guidance – Selected Indications (0952) covered if criteria are met Apr 27, 2026 payer document UnitedHealthcare Office-Based Procedures – Site of Service (MP.12.22)General Surgery listed, no stance Jul 1, 2026 payer document
Recent prior-auth changes Oct 1, 2026: PA removed, UnitedHealthcare Oct 1, 2026: PA removed, UnitedHealthcare Oct 1, 2026: PA removed, UnitedHealthcare Oct 1, 2026: PA removed, UnitedHealthcare Oct 1, 2026: PA removed, Oxford Health Plans Sep 1, 2026: conditions changed, UnitedHealthcare Aug 1, 2026: conditions changed, UnitedHealthcare Jul 1, 2026: conditions changed, UnitedHealthcare Jul 1, 2026: conditions changed, Neighborhood Health Partnership Jul 1, 2026: conditions changed, UnitedHealthcare Medicaid fee-for-service AZ: $35.82 (asc), effective Oct 1, 2026 CO: $51.29 (chp_plus, non-facility), effective Jul 1, 2026 FL: $29.19 (physician, facility), effective Jan 1, 2026 IL: $37.40 (practitioner), effective Jul 1, 2026 IN: $32.55 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $225.00 (asc, facility), effective Aug 1, 1982 KY: $63.90 (asc), effective Jan 1, 2026 LA: $233.58 (asc), effective Jul 1, 2012 MA: $66.26 (asc), effective May 1, 2026 MS: $50.46 (comprehensive, facility), effective Oct 1, 2025 ND: $63.20 (physician, facility), effective Aug 1, 2026 NE: $37.78 (physician, facility), effective Jul 1, 2026 NY: $21.96 (physician_surgery, facility), effective Jul 1, 2026 OH: $29.35 (physician, facility), effective Jan 1, 2024 OK: $58.30 (asc), effective Jan 1, 2026 TX: $59.25 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023 VA: $31.54 (medical, facility), effective Jul 1, 2026 VT: $549.84 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $21.02 (physician, facility), effective Jul 1, 2026 WY: $313.16 (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.