24360 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 24360

31 of 31 payer prior-auth lists that name 24360 require prior authorization or set conditions: Neighborhood Health Partnership, Rocky Mountain Health Plans, UnitedHealthcare, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
Neighborhood Health PartnershipNeighborhood Health PartnershipFLprior auth requiredSep 1, 2026Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026
Rocky Mountain Health PlansRocky Mountain Health Plans CHP+COprior auth requiredOct 1, 2026Rocky Mountain Children’s Health Plan - prior authorization Effective October 1, 2026
UnitedHealthcareUnitedHealthcare Complete (Individual & Family plans)Allprior auth requiredSep 1, 2026Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026
UnitedHealthcare Community PlanAHCCCS Complete Care (ACC)AZprior auth requiredOct 1, 2026Prior authorization requirements for AHCCCS Complete Care (ACC) Medicaid effective October 1, 2026
UnitedHealthcare Community PlanALTCS Developmentally DisabledAZprior auth requiredOct 1, 2026Prior authorization requirements for Arizona Developmental Disabilities Effective October 1, 2026
UnitedHealthcare Community PlanALTCS Long Term CareAZprior auth requiredOct 1, 2026Prior authorization requirements for Arizona Long Term Care Effective October 1, 2026
UnitedHealthcare Community PlanKanCareKSprior auth requiredOct 1, 2026Prior authorization requirements for Kansas Medicaid Effective October 1, 2026
UnitedHealthcare Community PlanLouisiana Medicaid (Healthy Louisiana)LAprior auth requiredJan 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Louisiana
UnitedHealthcare Community PlanMaryland HealthChoiceMDprior auth requiredSep 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Maryland Effective September 1, 2026
UnitedHealthcare Community PlanMassachusetts OneCareMAprior auth requiredNov 1, 2025Prior authorization requirements for Massachusetts OneCare Effective November 1, 2025
UnitedHealthcare Community PlanMassachusetts Senior Care Options (SCO)MAprior auth requiredNov 1, 2025CPT® is a registered trademark of the American Medical Association. Prior authorization requirements for Massachusetts Senior Care Options Effective November 1, 2025
UnitedHealthcare Community PlanMinnesota Metro MedicaidMNprior auth requiredOct 1, 2024Prior authorization requirements for Minnesota Medicaid Effective October 1, 2024
UnitedHealthcare Community PlanMississippi CHIPMSprior auth requiredApr 1, 2025Prior authorization requirements for Mississippi Children’s Health Insurance Program Effective Apr. 1, 2025
UnitedHealthcare Community PlanMississippiCANMSprior auth requiredApr 1, 2025Prior authorization requirements for UnitedHealthcare Community Plan of Mississippi – Mississippi Coordinated Access Network (MississippiCAN) Effective Apr. 1, 2025
UnitedHealthcare Community PlanMissouri MedicaidMOprior auth requiredJul 1, 2026Prior authorization requirements for Missouri Medicaid Effective July 1, 2026
UnitedHealthcare Community PlanNebraska Heritage HealthNEprior auth requiredJul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Nebraska Effective July 1, 2026 General Information This list contains prior authorization requirements for participating United
UnitedHealthcare Community PlanNew Mexico Turquoise CareNMprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of New Mexico Effective October 1, 2026
UnitedHealthcare Community PlanOhio MedicaidOHprior auth requiredNov 1, 2025Prior authorization requirements for Ohio Medicaid Effective November 1, 2025 General Information This list contains prior authorization requirements for participating UnitedHealthcare Community Plan
UnitedHealthcare Community PlanPennsylvania CHIPPAprior auth requiredJul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Pennsylvania CHIP Effective July 1, 2026
UnitedHealthcare Community PlanPennsylvania MedicaidPAprior auth requiredJul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Pennsylvania Effective July 1, 2026
UnitedHealthcare Community PlanRhode Island MedicaidRIprior auth requiredMay 1, 2026Prior authorization requirements for Rhode Island Medicaid Effective May 1, 2026 This list contains prior authorization requirements for participating UnitedHealthcare Community Plan of Rhode Island h
UnitedHealthcare Community PlanTennCareTNprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Tennessee Effective October 1, 2026
UnitedHealthcare Community PlanTexas CHIPTXprior auth requiredJan 1, 2015Prior authorization requirements for Texas CHIP Effective September 1, 2026 This list contains prior authorization requirements for participating UnitedHealthcare Community Plan Texas CHIP health care
UnitedHealthcare Community PlanTexas STARTXprior auth requiredJan 1, 2015Prior authorization requirements for Texas STAR Effective September 1, 2026 This list contains prior authorization review requirements for participating UnitedHealthcare Community Plan of Texas STAR h
UnitedHealthcare Community PlanTexas STAR KidsTXprior auth requiredNov 1, 2016Prior authorization requirements for STAR Kids Effective September 1, 2026 This list contains prior authorization review requirements for participating UnitedHealthcare Community Plan of Texas STAR Ki
UnitedHealthcare Community PlanTexas STAR+PLUSTXprior auth requiredJan 1, 2015Prior authorization requirements for STAR+Plus Effective September 1, 2026 This list contains prior authorization requirements for participating UnitedHealthcare Community Plan STAR+PLUS health care p
UnitedHealthcare Community PlanUnitedHealthcare Community Plan of KentuckyKYprior auth requiredJul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Kentucky Effective July 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Community Plan of New YorkNYprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of New York Effective October 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Connected (Texas MMP)TXprior auth requiredJan 1, 2015Prior authorization requirements for UnitedHealthcare Connected (Medicare-Medicaid Plan) Texas Effective November 1, 2025 This list contains prior authorization review requirements for participating U
UnitedHealthcare Community PlanWashington Apple HealthWAprior auth requiredOct 1, 2026Prior authorization requirements for the UnitedHealthcare Community Plan of Washington Effective April 1, 2023
UnitedHealthcare Community PlanWisconsin BadgerCare Plus and Medicaid SSIWIprior auth requiredSep 1, 2026Prior authorization requirements for Wisconsin Medicaid Effective September 1, 2026 General Information This list contains prior authorization requirements for participating UnitedHealthcare Community

Payer coverage policies that name 24360

24360 appears in 17 coverage policies from Aetna, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaElbow Arthroplasty (0857)covered if criteria are metDec 9, 2025payer document
AetnaIntraoperative Neurophysiological Monitoring (0697)not covered (range 23930-24999)Jun 19, 2026payer document
AetnaRemote Ischemic Conditioning (0814)listed, no stance (range 20000-29999)Nov 20, 2025payer document
AetnaSkin and Soft Tissue Substitutes (0244)listed, no stance (range 24360-24363)Jul 29, 2026payer document
AetnaSkin and Soft Tissue Substitutes (0244)not covered (range 20100-29999)Jul 29, 2026payer document
UnitedHealthcareJoint Procedures (MMP052.13)
Surgery of the Elbow		listed, no stanceJun 1, 2026payer document
UnitedHealthcareSurgery of the Elbow (2026T0551BB)listed, no stanceAug 1, 2026payer document
UnitedHealthcareSurgery of the Elbow (CS033.V)
Arthroplasty, Joint Replacement, Elbow		listed, no stanceSep 1, 2026payer document
UnitedHealthcareSurgery of the Elbow (for Idaho Only) (CS033ID.D)listed, no stanceSep 1, 2026payer document
UnitedHealthcareSurgery of the Elbow (for Kansas Only) (CS033KS.03)listed, no stanceSep 1, 2026payer document
UnitedHealthcareSurgery of the Elbow (for Kentucky Only) (CS033KY.11)
Arthroplasty, Joint Replacement, Elbow		listed, no stanceSep 1, 2026payer document
UnitedHealthcareSurgery of the Elbow (for Nebraska Only) (CS033NE.V)
Arthroplasty, Joint Replacement, Elbow		listed, no stanceJan 1, 2026payer document
UnitedHealthcareSurgery of the Elbow (for New Jersey Only) (CS033NJ.S)listed, no stanceSep 1, 2026payer document
UnitedHealthcareSurgery of the Elbow (for New Mexico Only) (CS033NM.D)listed, no stanceSep 1, 2026payer document
UnitedHealthcareSurgery of the Elbow (for North Carolina Only) (CSNCT0551.07)listed, no stanceSep 1, 2026payer document
UnitedHealthcareSurgery of the Elbow (for Ohio Only) (CS033OH.E)
Arthroplasty, Joint Replacement, Elbow		listed, no stanceSep 1, 2026payer document
UnitedHealthcareSurgery of the Elbow (for Pennsylvania Only) (CS033PA.T)
Arthroplasty, Joint Replacement, Elbow		listed, no stanceSep 1, 2026payer document
UnitedHealthcareSurgery of the Elbow (for Tennessee Only) (CS033TN.U)listed, no stanceSep 1, 2026payer document

Recent prior-auth changes

  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, Rocky Mountain Health Plans
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, Oxford Health Plans
  • Oct 1, 2026: PA removed, UnitedHealthcare Community Plan
  • Oct 1, 2026: PA removed, Surest
  • Oct 1, 2026: PA removed, UnitedHealthcare Community Plan
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, UnitedHealthcare Community Plan

Medicaid fee-for-service

Prior authorization required or conditional in WV.

  • AZ: $3853.23 (asc), effective Oct 1, 2026
  • CO: $725.20 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $651.51 (physician, non-facility), effective Jan 1, 2026
  • IL: $718.70 (practitioner), effective Jul 1, 2026
  • IN: $695.46 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $1063.67 (asc, facility), effective Apr 1, 2015
  • KY: $5082.98 (asc), effective Jan 1, 2026
  • LA: $233.58 (asc), effective Jul 1, 2012
  • MA: $2382.86 (asc), effective May 1, 2026
  • MS: $4012.33 (comprehensive, facility), effective Oct 1, 2025
  • ND: $2996.42 (physician, facility), effective Aug 1, 2026
  • NE: $1000.00 (asc), effective Jul 1, 2024
  • NY: $433.46 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $730.87 (physician), effective Jan 1, 2024
  • OK: $4637.31 (asc), effective Jan 1, 2026
  • TX: $3104.56 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $725.69 (medical), effective Jul 1, 2026
  • VT: $5634.17 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $446.73 (asc), effective Jul 1, 2026
  • WY: $3208.96 (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.