37298 CPT® code: payer coverage and prior authorization31 of 31 payer prior-auth lists that name 37298 require prior authorization or set conditions: CarePlus Health Plans, Cigna, Humana, Molina Healthcare of Illinois, Molina Healthcare of Michigan, Molina Healthcare of New Mexico, Molina Healthcare of Texas, Neighborhood Health Partnership, Oxford Health Plans, Passport by Molina Healthcare (Kentucky), Surest, UnitedHealthcare.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Cigna | ACA/IFP | All | prior auth required | May be delegated to eviCore for some clients | Jan 1, 2026 | Master Precertification List (For Health Care Providers) |
| Cigna | Complete/PHS+/Preferred | All | prior auth required | May be delegated to eviCore for some clients | Jan 1, 2026 | Master Precertification List (For Health Care Providers) |
| Cigna | Vascular Interventions | All | prior auth required | Mar 7, 2026 | Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs | |
| Cigna | Vascular Interventions | All | prior auth required | Mar 7, 2026 | Cigna Vascular Interventions Commercial Code List (title from file name) | |
| CarePlus Health Plans | CarePlus Health Plans | FL | prior auth required | Jan 1, 2027 | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List | |
| Humana | Cardiology Services | All | prior auth required | Humana Prior Authorization List (PAL): Cardiovascular and Endoscopy Services | ||
| Humana | Cardiology Services | All | prior auth required | Humana Prior Authorization List (PAL): Cardiovascular and Endoscopy Services | ||
| Humana | Cardiology Services | All | prior auth required | Humana Prior Authorization List (PAL): Cardiovascular and Endoscopy Services | ||
| Humana | Humana D-SNP (FL) | FL | prior auth required | Jan 1, 2027 | 1 *New prior authorization requirement 787403FL0725 FLHMQSREN Humana Dual Fully Integrated Florida Prior Authorization and Notification List | |
| Humana | Humana D-SNP (IL) | IL | prior auth required | Jan 1, 2027 | Humana Dual Fully Integrated Illinois Prior Authorization and Notification List | |
| Humana | Humana D-SNP (IN) | IN | prior auth required | Jan 1, 2027 | *New prior authorization requirement 814403IN0825 H4939_INHN6Z6EN_C Humana PathWays Dual Care (HMO-POS D-SNP) Indiana Prior Authorization and Notification List | |
| Humana | Humana D-SNP (MI) | MI | prior auth required | Jan 1, 2027 | 1 Humana Dual Highly Integrated Michigan Prior Authorization and Notification List | |
| Humana | Humana D-SNP (SC) | SC | prior auth required | Jan 1, 2027 | Humana Dual Highly Integrated South Carolina Prior Authorization and Notification List | |
| Humana | Humana D-SNP (VA) | VA | prior auth required | Jan 1, 2027 | Virginia Prior Authorization and Notification List | |
| Humana | Humana Healthy Horizons | IL | prior auth required | Jan 1, 2027 | Humana 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 . | |
| Humana | Humana MA and D-SNP | All | prior auth required | Jan 1, 2027 | Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List | |
| Molina Healthcare of Illinois | Medicaid | IL | prior auth required | Jul 1, 2026 | Molina Healthcare of Illinois Codification Grid Q3 2026 | |
| Molina Healthcare of Michigan | Medicare Advantage | MI | prior auth required | adults via Evolent | Jul 1, 2026 | Molina Healthcare of Michigan PA Matrix 2026-Q3 |
| Molina Healthcare of Michigan | Medicaid | MI | prior auth required | adults via Evolent | Jul 1, 2026 | Molina Healthcare of Michigan PA Matrix 2026-Q3 |
| Molina Healthcare of New Mexico | Medicaid | NM | prior auth required | Jul 1, 2026 | New Mexico Medicaid Prior Auth (PA) Code Matrix, effective July 1, 2026 | |
| Molina Healthcare of Texas | STAR, STAR+PLUS, STAR Kids, CHIP (Medicaid PA code matrix) | TX | prior auth required | Jul 1, 2026 | Medicaid Behavioral Health and Medical Prior Authorization (PA) Code Matrix (Texas), 2026-Q3 | |
| Passport by Molina Healthcare (Kentucky) | Medicaid | KY | prior auth required | adults via Evolent | Jul 1, 2026 | Kentucky Medicaid Prior Auth (PA) Code Matrix and Kentucky PA Code Exceptions, effective Q3 2026 |
| Neighborhood Health Partnership | Neighborhood Health Partnership | FL | prior auth under conditions | PA not required with dx E08.52, E09.52, E10.52, E11.52, E13.52, I70.221 (+283 more) | Sep 1, 2026 | Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026 |
| Oxford Health Plans | Oxford Health Plans | All | prior auth required | Oct 1, 2026 | Prior Authorization Requirements for Oxford Effective October 1, 2026 | |
| Surest | Surest health plans | All | prior auth under conditions | *Prior authorization for these codes is not required with the following Dx. | Oct 1, 2026 | Prior Authorization Requirements for Surest Effective October 1, 2026 |
| UnitedHealthcare | Preferred Care Network and Preferred Care Partners of Florida | FL | prior auth under conditions | PA not required with dx E08.52, E09.52, E10.52, E11.52, E13.52, I70.221 (+289 more) | Oct 1, 2026 | Prior authorization requirements for Preferred Care Network and Preferred Care Partners of Florida Effective October 1, 2026 |
| UnitedHealthcare | UnitedHealthcare Commercial | All | prior auth under conditions | PA not required with dx E08.52, E09.52, E10.52, E11.52, E13.52, I70.221 (+283 more) | Oct 1, 2026 | Prior authorization requirements for UnitedHealthcare commercial plans Effective October 1, 2026 |
| UnitedHealthcare | UnitedHealthcare Individual Exchange plans | All | prior auth under conditions | *Prior authorization is not required for these diagnosis codes. | Oct 1, 2026 | Prior authorization requirements for UnitedHealthcare Individual Exchange plans Effective October 1, 2026 |
| UnitedHealthcare | UnitedHealthcare Mid-Atlantic Health Plans | All | prior auth under conditions | PA not required with dx E08.52, E09.52, E10.52, E11.52, E13.52, I70.221 (+283 more) | Oct 1, 2026 | Prior authorization requirements for UnitedHealthcare Mid-Atlantic Health Plans Effective October 1, 2026 |
| UnitedHealthcare | UnitedHealthcare West commercial plans | All | prior auth required | Oct 1, 2026 | Prior authorization requirements for UnitedHealthcare West commercial plans Effective October 1, 2026 | |
| UnitedHealthcare | UnitedHealthcare of the River Valley | All | prior auth under conditions | PA not required with dx E08.52, E09.52, E10.52, E11.52, E13.52, I70.221 (+283 more) | Oct 1, 2026 | Prior authorization requirements for UnitedHealthcare of the River Valley Effective October 1, 2026 |
37298 appears in 22 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Anesthetic and Antiemetic Infusion Pumps (0607) | listed, no stance (range 33016-37799) | Sep 9, 2026 | payer document |
| Aetna | Bupivacaine Liposome (Exparel) (0941) | listed, no stance (range 33010-37799) | Jul 30, 2026 | payer document |
| Aetna | Cardiovascular Ultrafiltration (0741) | listed, no stance (range 33010-37790) | Oct 30, 2025 | payer document |
| Aetna | Negative Pressure Wound Therapy (0334) | listed, no stance (range 33016-37799) | Jun 8, 2026 | payer document |
| Aetna | Nitric Oxide, Inhalational (INO) (0518) | not covered (range 33016-37790) | Jul 2, 2026 | payer document |
| Aetna | Peripheral Atherectomy and Thrombectomy Devices (0295) | covered if criteria are met (range 37254-37299) | Apr 16, 2026 | payer document |
| Aetna | Stereolithographic Models and Implants (0613) | listed, no stance (range 33010-37790) | Sep 3, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Percutaneous Revascularization Procedures For Lower Extremity Peripheral Arterial Disease (A.7.01.178) | listed, no stance | payer document | |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Percutaneous Revascularization Procedures for Lower Extremity Peripheral Arterial Disease (SUR707.034) CPT Codes 37254, 37255, 37256, 37257, 37258, 37259, 37260, 37261, 37262, 37263, | listed, no stance | Jan 1, 2026 | payer document |
| Premera Blue Cross | Percutaneous Revascularization Procedures for Lower Extremity Peripheral Arterial Disease (7.01.594) Page | 12 of 33 | ∞ | listed, no stance | Sep 8, 2026 | payer document |
| UnitedHealthcare | Cardiovascular Diagnostic and Therapeutic Procedures (MMP013.22) Lower Extremity Endovascular Revascularization Procedures (e.g., Stenting, Atherectomy, and/or Angioplasty) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Lower Extremity Endovascular Procedures (CS166.P) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Lower Extremity Endovascular Procedures (2026T0602S) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Lower Extremity Endovascular Procedures (for Kansas Only) (CS166KS.03) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Lower Extremity Endovascular Procedures (for Kentucky Only) (CS166KY.12) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Lower Extremity Endovascular Procedures (for Nebraska Only) (CS166NE.P) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Lower Extremity Endovascular Procedures (for New Jersey Only) (CS166NJ.M) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Lower Extremity Endovascular Procedures (for New Mexico Only) (CS166NM.D) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Lower Extremity Endovascular Procedures (for North Carolina Only) (CSNCT0602.05) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Lower Extremity Endovascular Procedures (for Ohio Only) (CS166OH.D) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Lower Extremity Endovascular Procedures (for Pennsylvania Only) (CS166PA.N) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Lower Extremity Endovascular Procedures (for Tennessee Only) (CS166TN.O) | listed, no stance | Jun 1, 2026 | payer document |
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.