31529 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 31529

2 of 2 payer prior-auth lists that name 31529 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 31529

31529 appears in 2 coverage policies from Aetna, Blue Cross NC.

PayerPolicyRole in policyReviewedDocument
AetnaVoice Therapy (0646)listed, no stance (range 31505-31592)Sep 9, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 3011F-3210F)Mar 1, 2024payer 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
  • 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
  • Apr 1, 2026: PA removed, UnitedHealthcare Community Plan

Medicaid fee-for-service

  • AZ: $1082.27 (asc), effective Oct 1, 2026
  • CO: $127.40 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $110.99 (physician, non-facility), effective Jan 1, 2026
  • IL: $157.35 (practitioner), effective Apr 1, 2024
  • IN: $123.50 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $225.00 (asc, facility), effective Aug 1, 1982
  • KY: $1655.96 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $1052.05 (asc), effective May 1, 2026
  • MS: $1288.25 (comprehensive, facility), effective Oct 1, 2025
  • ND: $976.19 (physician, facility), effective Aug 1, 2026
  • NE: $637.00 (asc), effective Jul 1, 2024
  • OH: $135.31 (physician), effective Jan 1, 2000
  • OK: $1510.77 (asc), effective Jan 1, 2026
  • TX: $1062.24 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $119.50 (medical), effective Jul 1, 2026
  • VT: $2894.92 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), effective Jul 1, 2026
  • WY: $1648.81 (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.