31081 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 31081

1 of 1 payer prior-auth lists that name 31081 require prior authorization or set conditions: UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
UnitedHealthcare Community PlanMaryland HealthChoiceMDprior auth under conditionsonly with dx F64.0, F64.1, F64.2, F64.8, F64.9, Z87.890Sep 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Maryland Effective September 1, 2026

Payer coverage policies that name 31081

31081 appears in 4 coverage policies from Aetna, Blue Cross NC.

PayerPolicyRole in policyReviewedDocument
AetnaMyringotomy and Tympanostomy Tube (0418)listed, no stance (range 31000-31230)Jun 30, 2026payer document
AetnaObstructive Sleep Apnea in Adults (0004)not covered (range 30150-31235)Oct 6, 2026payer 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

Medicaid fee-for-service

  • AZ: $1943.46 (asc), effective Oct 1, 2026
  • CO: $598.60 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $815.68 (physician, non-facility), effective Jan 1, 2026
  • IL: $898.95 (practitioner), effective Jul 1, 2026
  • IN: $893.43 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $444.41 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $2953.46 (asc), effective Jan 1, 2026
  • LA: $217.00 (asc), effective Jul 1, 2012
  • MA: $1909.57 (asc), effective May 1, 2026
  • MS: $2333.88 (comprehensive, facility), effective Oct 1, 2025
  • ND: $1741.07 (physician, facility), effective Aug 1, 2026
  • NE: $1233.00 (asc), effective Jul 1, 2024
  • NY: $591.28 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $673.62 (physician), effective Jan 1, 2024
  • OK: $2694.50 (asc), effective Jan 1, 2026
  • TX: $1954.22 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $908.57 (medical), effective Jul 1, 2026
  • VT: $4596.52 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $366.60 (asc), effective Jul 1, 2026
  • WY: $2617.97 (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.