21032 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 21032

2 of 2 payer prior-auth lists that name 21032 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Humana.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross Blue Shield of Arizona (AZ Blue)Federal Employee Program (FEP)AZprior auth under conditionsFEP Blue Focus onlySep 1, 2026Federal Employee Program (FEP) Prior Authorization Requirements Code List (Updated 09/01/2026)
HumanaHumana Puerto Rico MA and Dual Medicare-MedicaidPRprior auth requiredNov 3, 2025Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification

Payer coverage policies that name 21032

21032 appears in 3 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaDental Services and Oral and Maxillofacial Surgery: Coverage Under Medical Plans (0082)covered if criteria are metMar 18, 2026payer document
AetnaRemote Ischemic Conditioning (0814)listed, no stance (range 20000-29999)Nov 20, 2025payer document
AetnaSkin and Soft Tissue Substitutes (0244)not covered (range 20100-29999)Jul 29, 2026payer document

Recent prior-auth changes

  • Feb 28, 2025: PA removed, Cigna
  • Feb 28, 2025: PA removed, Cigna

Medicaid fee-for-service

Prior authorization required or conditional in WA.

  • AZ: $143.44 (asc), effective Oct 1, 2026
  • CO: $254.04 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $189.89 (physician, facility), effective Jan 1, 2026
  • IL: $249.42 (practitioner), effective Apr 1, 2024
  • IN: $205.13 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $400.00 (asc, facility), effective Aug 1, 1982
  • KY: $255.91 (asc), effective Jan 1, 2026
  • LA: $291.43 (professional), effective Jul 1, 2025
  • MA: $229.46 (asc), effective May 1, 2026
  • MS: $196.41 (comprehensive, facility), effective Oct 1, 2025
  • ND: $253.12 (physician, facility), effective Aug 1, 2026
  • NE: $331.22 (physician, facility), effective Jul 1, 2026
  • NY: $136.51 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $141.88 (physician, facility), effective Jan 1, 2024
  • OK: $213.50 (physician, facility), effective Jul 1, 2026
  • TX: $204.87 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $211.52 (medical, facility), effective Jul 1, 2026
  • VT: $2574.33 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $146.57 (physician, facility), effective Jul 1, 2026
  • WY: $1466.22 (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.