49083 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 49083

2 of 2 payer prior-auth lists that name 49083 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross and Blue Shield of TexasTexas PA exemption (gold card), outpatient, fully insuredTXprior auth requiredGold-card exemption availableJul 1, 2026BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range)
UnitedHealthcare Community PlanMassachusetts Senior Care Options (SCO) and OneCareMAprior auth requiredOct 1, 2026Prior authorization requirements for Massachusetts MA SCO OneCare Effective October 1, 2026

Payer coverage policies that name 49083

49083 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaTransjugular Intrahepatic Portosystemic Shunt (TIPSS) (0259)listed, no stanceApr 14, 2026payer document

Recent prior-auth changes

  • Apr 1, 2026: PA removed, UnitedHealthcare Community Plan

Medicaid fee-for-service

  • AZ: $343.75 (asc), effective Oct 1, 2026
  • CO: $85.34 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $72.39 (physician, facility), effective Jan 1, 2026
  • IL: $71.41 (practitioner), effective Apr 1, 2024
  • IN: $81.74 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $144.42 (asc, facility), effective Jan 1, 2012
  • KY: $485.98 (asc), effective Jan 1, 2026
  • LA: $240.06 (professional), effective Feb 1, 2013
  • MA: $337.55 (asc), effective May 1, 2026
  • MS: $402.71 (comprehensive, facility), effective Oct 1, 2025
  • ND: $286.48 (physician, facility), effective Aug 1, 2026
  • NE: $185.24 (physician, non-facility), effective Jul 1, 2026
  • NY: $119.30 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $88.65 (physician, facility), effective Jan 1, 2024
  • OK: $443.37 (asc), effective Jan 1, 2026
  • TX: $334.95 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $80.44 (medical, facility), effective Jul 1, 2026
  • VT: $704.24 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $401.10 (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.