33218 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 33218

2 of 9 payer prior-auth lists that name 33218 require prior authorization or set conditions: Molina Healthcare of Ohio.

PayerPlanStatePrior authConditionsSinceSource
Molina Healthcare of OhioMedicaid and MyCare Ohio (MMP) MedicaidOHprior auth under conditionsno PA under 18Oct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of OhioExchangeOHprior auth under conditionsno PA under 18Oct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01

Payer coverage policies that name 33218

33218 appears in 16 coverage policies from Aetna, Blue Cross NC, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).

PayerPolicyRole in policyReviewedDocument
AetnaAnesthetic and Antiemetic Infusion Pumps (0607)listed, no stance (range 33016-37799)Sep 9, 2026payer document
AetnaBupivacaine Liposome (Exparel) (0941)listed, no stance (range 33010-37799)Jul 30, 2026payer document
AetnaCardiovascular Ultrafiltration (0741)listed, no stance (range 33010-37790)Oct 30, 2025payer document
AetnaCardioverter-Defibrillators (0585)covered if criteria are metApr 22, 2026payer document
AetnaCryoanalgesia and Therapeutic Cold (0297)listed, no stance (range 33016-33999)Apr 14, 2026payer document
AetnaFunctional Electrical Stimulation and Neuromuscular Electrical Stimulation (0677)listed, no stance (range 33016-33999)Sep 10, 2026payer document
AetnaInpatient Admission Prior to Surgery (Preop Days) (0255)listed, no stance (range 33016-33980)May 13, 2026payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 33016-33999)Jul 1, 2026payer document
AetnaNegative Pressure Wound Therapy (0334)listed, no stance (range 33016-37799)Jun 8, 2026payer document
AetnaNerve Blocks (0863)listed, no stance (range 33016-33999)Jul 23, 2026payer document
AetnaNitric Oxide, Inhalational (INO) (0518)not covered (range 33016-37790)Jul 2, 2026payer document
AetnaObstructive Sleep Apnea in Adults (0004)not covered (range 33202-33249)Oct 6, 2026payer document
AetnaProcalcitonin (PCT) (0771)listed, no stance (range 33016-33997)Nov 13, 2025payer document
AetnaStereolithographic Models and Implants (0613)listed, no stance (range 33010-37790)Sep 3, 2026payer document
Blue Cross NCImplantable Cardioverter Defibrillatorlisted, no stanceJun 1, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Implantable Cardioverter Defibrillators (SUR707.003)
CPT Codes 0571T, 0572T, 0573T, 0574T, 0575T, 0576T, 0577T, 0578T, 0579T, 0580T,
listed, no stanceDec 15, 2025payer document

Recent prior-auth changes

  • Jan 1, 2026: PA removed, Molina Healthcare of Illinois
  • Jan 1, 2026: PA removed, Molina Healthcare of Michigan
  • Jul 1, 2024: conditions changed, Molina Healthcare of Illinois
  • Jan 1, 2024: PA added, Molina Healthcare of Michigan

Medicaid fee-for-service

  • AZ: $1596.88 (asc), effective Oct 1, 2026
  • CO: $280.60 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $270.94 (physician, non-facility), effective Jan 1, 2026
  • IL: $299.70 (practitioner), effective Jan 1, 2012
  • IN: $289.65 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $350.00 (asc, facility), effective Aug 1, 1982
  • KY: $2042.30 (asc), effective Jan 1, 2026
  • LA: $322.58 (professional), effective Feb 1, 2013
  • MA: $1281.61 (asc), effective May 1, 2026
  • MS: $1563.06 (comprehensive, facility), effective Oct 1, 2025
  • ND: $1203.94 (physician, facility), effective Aug 1, 2026
  • NE: $134.64 (physician, non-facility), effective Jul 1, 2026
  • NY: $204.04 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $284.66 (physician), effective Jan 1, 2024
  • OK: $305.43 (physician, non-facility), effective Jul 1, 2026
  • TX: $1425.44 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $301.79 (medical), effective Jul 1, 2026
  • VT: $2901.60 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), effective Jul 1, 2026
  • WY: $1652.62 (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.