20974 CPT® code: payer coverage and prior authorization21 of 21 payer prior-auth lists that name 20974 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Texas, Neighborhood Health Partnership, Oxford Health Plans, Rocky Mountain Health Plans, Surest, UnitedHealthcare, UnitedHealthcare Community Plan.
20974 appears in 34 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Blue Shield of California, BlueCross BlueShield of South Carolina, Capital Blue Cross, Centene, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Bone Growth Stimulators (0343) | covered if criteria are met | May 26, 2026 | payer document |
| Aetna | Bone and Tendon Graft Substitutes and Adjuncts (0411) | listed, no stance | Aug 18, 2026 | payer document |
| Aetna | Complementary and Alternative Medicine (0388) | listed, no stance | Jun 25, 2026 | 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 |
| Anthem | Noninvasive Electrical Bone Growth Stimulation of the Appendicular Skeleton (CG-DME-40) | covered if criteria are met | Feb 19, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Electrical Bone Growth Stimulation Of The Appendicular Skeleton | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Mississippi | Electrical Stimulation Of The Spine As An Adjunct To Spinal Fusion Procedures | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Mississippi | Interferential Current Stimulation | unproven / investigational | payer document | |
| Blue Cross Blue Shield of Massachusetts | Electrical Bone Growth Stimulation of the Appendicular Skeleton (499) | listed, no stance | payer document | |
| Blue Cross Blue Shield of Massachusetts | Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures (498) | listed, no stance | payer document | |
| Blue Cross NC | Electrical Bone Growth Stimulation | listed, no stance | Jun 1, 2026 | payer document |
| Blue Shield of California | Electrical Bone Growth Stimulation of the Appendicular Skeleton (7.01.07) | listed, no stance | payer document | |
| Blue Shield of California | Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures (7.01.85) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Electrical Bone Growth Stimulation of the Appendicular Skeleton (CAM 70107) | listed, no stance | Dec 1, 2025 | payer document |
| BlueCross BlueShield of South Carolina | Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures (CAM 70185) | listed, no stance | May 1, 2026 | payer document |
| Capital Blue Cross | Electrical Bone Growth Stimulation of the Appendicular Skeleton (MP 1.024) Procedure codes | covered if criteria are met | Sep 1, 2026 | payer document |
| Centene | Osteogenic Stimulation (CP.MP.194) | covered if criteria are met | May 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Electrical Bone Growth Stimulation of the Appendicular Skeleton (SUR705.044) | listed, no stance | Oct 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures (SUR705.013) | listed, no stance | Oct 15, 2026 | payer document |
| Premera Blue Cross | Electrical Bone Growth Stimulation of the Appendicular Skeleton (7.01.07) | listed, no stance | Jun 8, 2026 | payer document |
| Premera Blue Cross | Electrical Stimulation of the Spine as an Adjunct to Spinal Fusion Procedures (7.01.85) | listed, no stance | Jul 13, 2026 | payer document |
| UnitedHealthcare | Electrical and Ultrasonic Bone Growth Stimulators (CS037.T) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Electrical and Ultrasonic Bone Growth Stimulators (2026T0561X) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Electrical and Ultrasonic Bone Growth Stimulators (for Idaho Only) (CS037ID.C) Electrical Bone Growth Stimulator: Non-Spinal (Invasive, Non-Invasive) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Electrical and Ultrasonic Bone Growth Stimulators (for Kansas Only) (CS037KS.02) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Electrical and Ultrasonic Bone Growth Stimulators (for Kentucky Only) (CS037KY.10) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Electrical and Ultrasonic Bone Growth Stimulators (for Nebraska Only) (CS037NE.S) Electrical Bone Growth Stimulator: Non-Spinal (Invasive, Non-Invasive) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Electrical and Ultrasonic Bone Growth Stimulators (for New Jersey Only) (CS037NJ.V) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Electrical and Ultrasonic Bone Growth Stimulators (for New Mexico Only) (CS037NM.C) Electrical Bone Growth Stimulator: Non-Spinal (Invasive, Non-Invasive) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Electrical and Ultrasonic Bone Growth Stimulators (for North Carolina Only) (CSNCT0561.06) Electrical Bone Growth Stimulator: Non-Spinal (Invasive, Non-invasive) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Electrical and Ultrasonic Bone Growth Stimulators (for Ohio Only) (CS037OH.D) Electrical Bone Growth Stimulator: Non-Spinal (Invasive, Non-Invasive) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Electrical and Ultrasonic Bone Growth Stimulators (for Pennsylvania Only) (CS037PA.S) | listed, no stance | payer document | |
| UnitedHealthcare | Electrical and Ultrasonic Bone Growth Stimulators (for Tennessee Only) (CS037TN.S) | listed, no stance | Feb 1, 2026 | payer document |
Prior authorization required or conditional in NY, VA, WA.
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.