44388 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 44388

2 of 2 payer prior-auth lists that name 44388 require prior authorization or set conditions: Neighborhood Health Partnership, UnitedHealthcare.

PayerPlanStatePrior authConditionsSinceSource
Neighborhood Health PartnershipNeighborhood Health PartnershipFLprior auth requiredsite of care: site of service reviewedSep 1, 2026Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026
UnitedHealthcareUnitedHealthcare Complete (Individual & Family plans)Allprior auth under conditionssite of care: outpatient hospitalSep 1, 2026Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026

Payer coverage policies that name 44388

44388 appears in 7 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Centene.

PayerPolicyRole in policyReviewedDocument
AetnaColonoscopy, Colorectal Cancer Screening, and Related Procedures (0516)covered if criteria are met (range 44388-44394)Aug 20, 2026payer document
AetnaExhaled Breath Tests (0691)listed, no stance (range 44388-44408)Oct 16, 2025payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 44005-44799)Jul 1, 2026payer document
AetnaRisankizumab-rzaa (Skyrizi) (1009)listed, no stance (range 44380-44408)Jul 1, 2026payer document
AnthemColonoscopy (CG-SURG-01)covered if criteria are metAug 13, 2026payer document
Blue Cross & Blue Shield of MississippiColonoscopy Flexible Sigmoidoscopy And Ct Colonography (L.2.04.403)covered if criteria are metpayer document
CenteneAnesthesiology Services for Gastrointestinal Endoscopy (CP.MP.161)covered if criteria are metMay 1, 2019payer document

Recent prior-auth changes

  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, Oxford Health Plans
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Aug 1, 2026: conditions changed, UnitedHealthcare
  • Jul 1, 2026: conditions changed, UnitedHealthcare
  • Dec 1, 2024: conditions changed, Oxford Health Plans

Medicaid fee-for-service

  • AZ: $297.60 (asc), effective Oct 1, 2026
  • CO: $122.30 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $109.62 (physician, facility), effective Jan 1, 2026
  • IL: $152.10 (practitioner), effective Apr 1, 2024
  • IN: $118.66 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $225.00 (asc, facility), effective Aug 1, 1982
  • KY: $498.31 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $328.08 (asc), effective May 1, 2026
  • MS: $391.58 (comprehensive, facility), effective Oct 1, 2025
  • ND: $293.76 (physician, facility), effective Aug 1, 2026
  • NE: $413.00 (asc), effective Jul 1, 2024
  • NY: $79.18 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $79.25 (physician, facility), effective Jan 1, 2024
  • OK: $454.62 (asc), effective Jan 1, 2026
  • TX: $328.50 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $122.11 (medical, facility), effective Jul 1, 2026
  • VT: $722.08 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $411.26 (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.