51102 CPT® code: payer coverage and prior authorization3 of 3 payer prior-auth lists that name 51102 require prior authorization or set conditions: Humana, Neighborhood Health Partnership, UnitedHealthcare.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Humana | Humana Puerto Rico MA and Dual Medicare-Medicaid | PR | prior auth required | Nov 3, 2025 | Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification | |
| Neighborhood Health Partnership | Neighborhood Health Partnership | FL | prior auth under conditions | site of care: outpatient hospital; not in AK, IL, GU, MA, PR, RI, TX, UT, VI, WI | Sep 1, 2026 | Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026 |
| UnitedHealthcare | UnitedHealthcare Complete (Individual & Family plans) | All | prior auth under conditions | site of care: outpatient hospital | Sep 1, 2026 | Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026 |
51102 appears in 4 coverage policies from Aetna, Centene, Regence.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Bupivacaine Liposome (Exparel) (0941) | listed, no stance (range 50010-53899) | Jul 30, 2026 | payer document |
| Aetna | Gender Affirming Surgery (0615) | covered if criteria are met | Sep 8, 2026 | payer document |
| Centene | Ambulatory Surgery Center Optimization Reference Number: CP.MP.158 (CP.MP.158) References reviewed and updated | 01/19 | 01/19 | covered if criteria are met | Jun 1, 2022 | payer document |
| Regence | Surgical Site of Care – Hospital Outpatient (Utilization Management 19) | listed, no stance | May 1, 2026 | payer document |
Prior authorization required or conditional in WV.
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.