44394 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 44394

2 of 2 payer prior-auth lists that name 44394 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 44394

44394 appears in 8 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Centene, Regence.

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
RegenceSurgical Site of Care – Colonoscopy and Sigmoidoscopy (Utilization Management 20)listed, no stanceFeb 1, 2026payer 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: $383.41 (asc), effective Oct 1, 2026
  • CO: $176.20 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $155.34 (physician, facility), effective Jan 1, 2026
  • IL: $218.49 (practitioner), effective Apr 1, 2024
  • IN: $171.24 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $225.00 (asc, facility), effective Jan 1, 1994
  • KY: $641.09 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $431.31 (asc), effective May 1, 2026
  • MS: $506.37 (comprehensive, facility), effective Oct 1, 2025
  • ND: $377.92 (physician, facility), effective Aug 1, 2026
  • NE: $413.00 (asc), effective Jul 1, 2024
  • NY: $151.50 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $220.66 (physician, facility), effective Jan 1, 2024
  • OK: $584.88 (asc), effective Jan 1, 2026
  • TX: $429.26 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $173.03 (medical, facility), effective Jul 1, 2026
  • VT: $929.15 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $529.20 (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.