49412 CPT® code: payer coverage and prior authorization3 of 5 payer prior-auth lists that name 49412 require prior authorization or set conditions: Cigna.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Cigna | ACA/IFP | All | prior auth required | May be delegated to eviCore for some clients | Aug 1, 2012 | Master Precertification List (For Health Care Providers) |
| Cigna | Basic Standard | All | prior auth required | May be delegated to eviCore for some clients | Aug 1, 2012 | Master Precertification List (For Health Care Providers) |
| Cigna | Complete/PHS+/Preferred | All | prior auth required | May be delegated to eviCore for some clients | Aug 1, 2012 | Master Precertification List (For Health Care Providers) |
49412 appears in 2 coverage policies from Aetna.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Brachytherapy (0371) | covered if criteria are met | May 20, 2026 | payer document |
| Aetna | Intensity Modulated Radiation Therapy (0590) | covered if criteria are met | Sep 8, 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.