Payer policies › CPT 3153031530 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 31530 2 of 2 payer prior-auth lists that name 31530 require prior authorization or set conditions: Neighborhood Health Partnership, UnitedHealthcare.
Payer Plan State Prior auth Conditions Since Source Neighborhood Health Partnership Neighborhood Health Partnership FL prior auth under conditions site of care: outpatient hospital; not in AK, IL, GU, MA, PR, RI, TX, UT, VI, WI Sep 1, 2026 Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026 UnitedHealthcare UnitedHealthcare Complete (Individual & Family plans) All prior auth under conditions site of care: outpatient hospital Sep 1, 2026 Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026
Payer coverage policies that name 31530 31530 appears in 2 coverage policies from Aetna, Blue Cross NC.
Payer Policy Role in policy Reviewed Document Aetna Voice Therapy (0646) listed, no stance (range 31505-31592) Sep 9, 2026 payer document Blue Cross NC Professional Pathology Billing Requirements AHS – R2169 listed, no stance (range 3011F-3210F) Mar 1, 2024 payer document
Recent prior-auth changes 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 Oct 1, 2026: PA removed, Oxford Health Plans 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: $499.77 (asc), effective Oct 1, 2026 CO: $161.84 (chp_plus, non-facility), effective Jul 1, 2026 FL: $136.95 (physician, non-facility), effective Jan 1, 2026 IL: $192.95 (practitioner), effective Jul 1, 2026 IN: $152.09 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $189.00 (asc, facility), effective Aug 1, 1982 KY: $823.65 (asc), effective Jan 1, 2026 LA: $182.30 (asc), effective Jul 1, 2012 MA: $519.94 (asc), effective May 1, 2026 MS: $633.71 (comprehensive, facility), effective Oct 1, 2025 ND: $485.54 (physician, facility), effective Aug 1, 2026 NE: $413.00 (asc), effective Jul 1, 2024 NY: $121.20 (physician_surgery, facility), effective Jul 1, 2026 OH: $169.76 (physician), effective Jan 1, 2010 OK: $751.43 (asc), effective Jan 1, 2026 TX: $525.71 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023 VA: $149.88 (medical), effective Jul 1, 2026 VT: $1382.02 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $308.28 (asc), effective Jul 1, 2026 WY: $787.13 (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.