33418 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 33418

32 of 33 payer prior-auth lists that name 33418 require prior authorization or set conditions: CarePlus Health Plans, Cigna, HealthSpring, Humana, Molina Complete Care (Virginia), Molina Healthcare of California, Molina Healthcare of Illinois, Molina Healthcare of Iowa, Molina Healthcare of Michigan, Molina Healthcare of Mississippi, Molina Healthcare of Nevada, Molina Healthcare of New Mexico, Molina Healthcare of Ohio, Molina Healthcare of Utah, Passport by Molina Healthcare (Kentucky).

PayerPlanStatePrior authConditionsSinceSource
CignaACA/IFPAllprior auth requiredMay be delegated to eviCore for some clientsJan 1, 2015Master Precertification List (For Health Care Providers)
CignaCardiologyAllprior auth requiredMar 7, 2026Cigna Commercial Prior Authorization Procedure Code List: Cardiology
CignaCardiologyAllprior auth requiredMar 7, 2026Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs
CignaComplete/PHS+/PreferredAllprior auth requiredMay be delegated to eviCore for some clientsJan 1, 2015Master Precertification List (For Health Care Providers)
HealthSpringMedicare AdvantageAllprior auth requiredJan 1, 20252026 Q4 Prior Authorization List
CarePlus Health PlansCarePlus Health PlansFLprior auth requiredJan 1, 2027Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List
HumanaCardiology ServicesAllprior auth requiredHumana Prior Authorization List (PAL): Cardiovascular and Endoscopy Services
HumanaCardiology ServicesAllprior auth requiredHumana Prior Authorization List (PAL): Cardiovascular and Endoscopy Services
HumanaCardiology ServicesAllprior auth requiredHumana Prior Authorization List (PAL): Cardiovascular and Endoscopy Services
HumanaHumana D-SNP (FL)FLprior auth requiredJan 1, 20271 *New prior authorization requirement 787403FL0725 FLHMQSREN Humana Dual Fully Integrated Florida Prior Authorization and Notification List
HumanaHumana D-SNP (IL)ILprior auth requiredJan 1, 2027Humana Dual Fully Integrated Illinois Prior Authorization and Notification List
HumanaHumana D-SNP (IN)INprior auth requiredJan 1, 2027*New prior authorization requirement 814403IN0825 H4939_INHN6Z6EN_C Humana PathWays Dual Care (HMO-POS D-SNP) Indiana Prior Authorization and Notification List
HumanaHumana D-SNP (MI)MIprior auth requiredJan 1, 20271 Humana Dual Highly Integrated Michigan Prior Authorization and Notification List
HumanaHumana D-SNP (SC)SCprior auth requiredJan 1, 2027Humana Dual Highly Integrated South Carolina Prior Authorization and Notification List
HumanaHumana D-SNP (VA)VAprior auth requiredJan 1, 2027Virginia Prior Authorization and Notification List
HumanaHumana Healthy HorizonsILprior auth requiredJan 1, 2027Humana Healthy Horizons in Illinois Prior Authorization and Notification List To view -specific medical coverage policies, please visit Humana Healthy Horizons in Illinois Clinical coverage policies .
HumanaHumana MA and D-SNPAllprior auth requiredJan 1, 2027Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List
HumanaHumana Puerto Rico MA and Dual Medicare-MedicaidPRprior auth requiredNov 3, 2025Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification
HumanaOak Street HealthAllprior auth requiredOak Street Health (Humana): Prior Authorization List (PAL) Codes Under Management
Molina Complete Care (Virginia)MedicaidVAprior auth requiredApr 1, 2025Virginia Medicaid PA Code Matrix and Virginia code/benefit exceptions, effective Q2 2025
Molina Healthcare of CaliforniaMedicaidCAprior auth requiredApr 1, 2026Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026
Molina Healthcare of IllinoisMedicaidILprior auth requiredApr 1, 2023Molina Healthcare of Illinois Codification Grid Q3 2026
Molina Healthcare of IowaMedicaidIAprior auth requiredJul 1, 2023IA Prior Authorization Matrix, effective Q3 2023
Molina Healthcare of MichiganMedicaidMIprior auth requiredadults via EvolentJul 1, 2026Molina Healthcare of Michigan PA Matrix 2026-Q3
Molina Healthcare of MichiganMedicare AdvantageMIprior auth requiredadults via EvolentJul 1, 2026Molina Healthcare of Michigan PA Matrix 2026-Q3
Molina Healthcare of MississippiMedicaidMSprior auth requiredadults via EvolentJan 1, 2025Mississippi Medicaid Prior Auth (PA) Code Matrix and exceptions, effective Q1 2025
Molina Healthcare of NevadaMedicaidNVprior auth requiredadults via NCHOct 1, 2022Medicaid Prior Auth (PA) Code Matrix, effective Q4 2022
Molina Healthcare of New MexicoMedicaidNMprior auth requiredJul 1, 2026New Mexico Medicaid Prior Auth (PA) Code Matrix, effective July 1, 2026
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
Molina Healthcare of UtahMedicaidUTprior auth requiredJan 1, 2025Utah Medicaid Prior Auth (PA) Code Matrix and Utah code/benefit exceptions, Q1 2025
Passport by Molina Healthcare (Kentucky)MedicaidKYprior auth requiredadults via EvolentJul 1, 2026Kentucky Medicaid Prior Auth (PA) Code Matrix and Kentucky PA Code Exceptions, effective Q3 2026

Payer coverage policies that name 33418

33418 appears in 32 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, BlueCross BlueShield of South Carolina, Cigna, Premera Blue Cross, UnitedHealthcare.

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
AetnaCardiac Rehabilitation: Outpatient (0021)listed, no stance (range 33418-33419)Mar 10, 2026payer document
AetnaCardiovascular Ultrafiltration (0741)listed, no stance (range 33010-37790)Oct 30, 2025payer 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
AetnaPercutaneous Mitral Valve and Tricuspid Valve Repair (0880)covered if criteria are met (range 33418-33419)Aug 25, 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
AetnaVentricular Assist Devices (0654)not coveredSep 10, 2026payer document
AnthemTranscatheter Mitral, Pulmonary, and Tricuspid Heart Valve Procedures (SURG.00121)covered if criteria are metFeb 19, 2026payer document
Blue Cross & Blue Shield of MississippiTranscatheter Mitral Valve Repair Or Replacementlisted, no stancepayer document
Blue Cross & Blue Shield of Rhode IslandTranscatheter Mitral Valve Repair or Replacement
Medicare Advantage Plans
listed, no stanceSep 17, 2025payer document
BlueCross BlueShield of South CarolinaTranscatheter Mitral Valve Repair (CAM 20230)listed, no stanceNov 1, 2025payer document
CignaTranscatheter Heart Valve Procedures (0501)covered if criteria are metDec 15, 2025payer document
Premera Blue CrossTranscatheter Mitral Valve Repair or Replacement (2.02.30)
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listed, no stanceJul 8, 2025payer document
UnitedHealthcareTranscatheter Procedures for Heart Valve Conditions (CS123.X)listed, no stanceAug 1, 2026payer document
UnitedHealthcareTranscatheter Procedures for Heart Valve Conditions (2026T0557FF)listed, no stanceJul 1, 2026payer document
UnitedHealthcareTranscatheter Procedures for Heart Valve Conditions (for Idaho Only) (CS123ID.C)listed, no stanceAug 1, 2026payer document
UnitedHealthcareTranscatheter Procedures for Heart Valve Conditions (for Kansas Only) (CS123KS.03)listed, no stanceAug 1, 2026payer document
UnitedHealthcareTranscatheter Procedures for Heart Valve Conditions (for Kentucky Only) (CS123KY.14)listed, no stanceSep 1, 2026payer document
UnitedHealthcareTranscatheter Procedures for Heart Valve Conditions (for Nebraska Only) (CS123NE.V)listed, no stanceAug 1, 2026payer document
UnitedHealthcareTranscatheter Procedures for Heart Valve Conditions (for New Jersey Only) (CS123NJ.S)listed, no stanceAug 1, 2026payer document
UnitedHealthcareTranscatheter Procedures for Heart Valve Conditions (for New Mexico Only) (CS123NM.D)listed, no stanceAug 1, 2026payer document
UnitedHealthcareTranscatheter Procedures for Heart Valve Conditions (for Ohio Only) (CS123OH.F)listed, no stanceAug 1, 2026payer document
UnitedHealthcareTranscatheter Procedures for Heart Valve Conditions (for Pennsylvania Only) (CS123PA.X)listed, no stanceAug 1, 2026payer document
UnitedHealthcareTranscatheter Procedures for Heart Valve Conditions (for Tennessee Only) (CS123TN.W)listed, no stanceAug 1, 2026payer document

Recent prior-auth changes

  • Oct 1, 2026: PA removed, Oxford Health Plans
  • Jan 1, 2026: PA added, Molina Healthcare of Michigan
  • Jan 1, 2024: PA added, Molina Healthcare of Michigan

Medicaid fee-for-service

  • AZ: $1796.70 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $1418.09 (chp_plus, non-facility), effective Jul 1, 2026
  • IL: $1249.37 (practitioner), effective Apr 1, 2024
  • IN: $1322.98 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $929.44 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $1503.43 (physician, facility), effective Jan 1, 2026
  • LA: $1730.93 (professional), effective Jan 1, 2015
  • MA: $1284.03 (physician_surgery), effective May 1, 2024
  • MS: $1329.58 (comprehensive), effective Jul 1, 2026
  • ND: $1611.61 (physician), effective Aug 1, 2026
  • NE: $2964.00 (physician, non-facility), effective Jul 1, 2026
  • NY: $1062.26 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $1391.86 (physician), effective Jan 1, 2015
  • OK: $1400.04 (physician, non-facility), effective Jul 1, 2026
  • VA: $1369.50 (medical, facility), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $904.09 (physician, facility), effective Jul 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.