20527 CPT® code: payer coverage and prior authorization4 of 4 payer prior-auth lists that name 20527 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas, Cigna.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Cigna | ACA/IFP | All | prior auth required | Aug 6, 2012 | Master Precertification List (For Health Care Providers) | |
| Cigna | Basic Standard | All | prior auth required | Aug 6, 2012 | Master Precertification List (For Health Care Providers) | |
| Cigna | Complete/PHS+/Preferred | All | prior auth required | Aug 6, 2012 | Master Precertification List (For Health Care Providers) | |
| Blue Cross and Blue Shield of Texas | Texas PA exemption (gold card), outpatient, fully insured | TX | prior auth required | Gold-card exemption available | Jul 1, 2026 | BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range) |
20527 appears in 11 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, BlueCross BlueShield of South Carolina, Cigna, Premera Blue Cross, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Dupuytren's Contracture Treatments (0800) | covered if criteria are met | Nov 20, 2025 | payer document |
| Aetna | Remote Ischemic Conditioning (0814) | listed, no stance (range 20000-29999) | Nov 20, 2025 | payer document |
| Aetna | Skin and Soft Tissue Substitutes (0244) | not covered (range 20100-29999) | Jul 29, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Xiaflex Collagenase Clostridium Histolyticum (L.5.01.492) | listed, no stance | payer document | |
| Blue Cross & Blue Shield of Mississippi | Xiaflex Collagenase Clostridium Histolyticum (S.5.01.492) | listed, no stance | payer document | |
| Blue Cross Blue Shield of Massachusetts | Med UM Policy (033) | covered if criteria are met | payer document | |
| BlueCross BlueShield of South Carolina | Injectable Clostridial Collagenase for Fibroproliferative Disorders (CAM 50119) Number | listed, no stance | Jan 1, 2026 | payer document |
| Cigna | Xiaflex (IP0143) | covered if criteria are met | Sep 15, 2026 | payer document |
| Premera Blue Cross | Injectable Clostridial Collagenase for Fibroproliferative Disorders (5.01.595) | listed, no stance | May 25, 2026 | payer document |
| UnitedHealthcare | Xiaflex® (Collagenase Clostridium Histolyticum) (2026D0099F) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Xiaflex® (Collagenase Clostridium Histolyticum) (CS2026D0099L) | listed, no stance | Apr 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.