34714 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 34714

7 of 13 payer prior-auth lists that name 34714 require prior authorization or set conditions: Molina Healthcare of California, Molina Healthcare of Illinois, Molina Healthcare of Michigan, Molina Healthcare of Nevada, Molina Healthcare of Ohio.

PayerPlanStatePrior authConditionsSinceSource
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 MichiganMedicare AdvantageMIprior auth requiredadults via EvolentJul 1, 2026Molina Healthcare of Michigan PA Matrix 2026-Q3
Molina Healthcare of MichiganMedicaidMIprior auth under conditionsadults via Evolent; no PA for pediatricsJul 1, 2026Molina Healthcare of Michigan PA Matrix 2026-Q3
Molina Healthcare of NevadaMedicaidNVprior auth requiredadults via NCHOct 1, 2022Medicaid Prior Auth (PA) Code Matrix, effective Q4 2022
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 34714

34714 appears in 9 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi.

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
AetnaLung Transplantation (0598)covered if criteria are metSep 8, 2026payer document
AetnaNegative Pressure Wound Therapy (0334)listed, no stance (range 33016-37799)Jun 8, 2026payer document
AetnaNitric Oxide, Inhalational (INO) (0518)not covered (range 33016-37790)Jul 2, 2026payer document
AetnaStereolithographic Models and Implants (0613)listed, no stance (range 33010-37790)Sep 3, 2026payer document
AetnaUrological Supplies (0533)listed, no stance (range 34701-34834)Jul 30, 2026payer document
Blue Cross & Blue Shield of MississippiEndovascular Stent Grafts For Abdominal Aortic Aneurysmscovered if criteria are metpayer document

Recent prior-auth changes

  • Jan 1, 2026: PA added, 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: $267.43 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $204.62 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $190.67 (physician, non-facility), effective Jan 1, 2026
  • IL: $183.66 (practitioner), effective Apr 1, 2024
  • IN: $196.13 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $136.50 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $0.00 (asc), effective Jan 1, 2026
  • LA: $251.32 (professional), effective Jan 1, 2018
  • MA: $0.00 (asc), effective May 1, 2026
  • MS: $206.68 (comprehensive), effective Jul 1, 2026
  • ND: $247.07 (physician), effective Aug 1, 2026
  • NE: $481.64 (physician, non-facility), effective Jul 1, 2026
  • NY: $152.10 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $220.96 (physician), effective Jan 1, 2018
  • OK: $217.47 (physician, non-facility), effective Jul 1, 2026
  • TX: $196.20 (physician, Physician, facility), effective Sep 1, 2026
  • VA: $212.38 (medical, facility), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $139.12 (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.