30310 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 30310

2 of 2 payer prior-auth lists that name 30310 require prior authorization or set conditions: Neighborhood Health Partnership, UnitedHealthcare.

PayerPlanStatePrior authConditionsSinceSource
Neighborhood Health PartnershipNeighborhood Health PartnershipFLprior auth under conditionssite of care: outpatient hospital; not in AK, IL, GU, MA, PR, RI, TX, UT, VI, WISep 1, 2026Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026
UnitedHealthcareUnitedHealthcare Complete (Individual & Family plans)Allprior auth under conditionssite of care: outpatient hospitalSep 1, 2026Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026

Payer coverage policies that name 30310

30310 appears in 5 coverage policies from Aetna, Blue Cross NC, Regence.

PayerPolicyRole in policyReviewedDocument
AetnaObstructive Sleep Apnea in Adults (0004)not covered (range 30150-31235)Oct 6, 2026payer document
AetnaObstructive Sleep Apnea in Children (0752)not covered (range 30000-30999)Oct 30, 2025payer document
AetnaTezepelumab-ekko (Tezspire) (1003)listed, no stance (range 30000-31299)Aug 6, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 3011F-3210F)Mar 1, 2024payer document
RegenceSurgical Site of Care – Hospital Outpatient (Utilization Management 19)listed, no stanceMay 1, 2026payer document

Recent prior-auth changes

  • Oct 1, 2026: PA removed, Oxford Health Plans
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, UnitedHealthcare Community Plan
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Aug 1, 2026: conditions changed, UnitedHealthcare
  • Jul 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: $926.87 (asc), effective Oct 1, 2026
  • CO: $171.53 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $148.07 (physician, non-facility), effective Jan 1, 2026
  • IL: $138.87 (practitioner), effective Apr 1, 2024
  • IN: $158.50 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $200.00 (asc, facility), effective Aug 1, 1982
  • KY: $1445.19 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $896.80 (asc), effective May 1, 2026
  • MS: $1115.56 (comprehensive, facility), effective Oct 1, 2025
  • ND: $851.94 (physician, facility), effective Aug 1, 2026
  • NE: $413.00 (asc), effective Jul 1, 2024
  • NY: $99.31 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $113.28 (physician), effective Jan 1, 2024
  • OK: $1318.48 (asc), effective Jan 1, 2026
  • TX: $886.62 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $164.93 (medical), effective Jul 1, 2026
  • VT: $2574.33 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), 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.