52443 CPT® code: payer coverage and prior authorization1 of 1 payer prior-auth lists that name 52443 require prior authorization or set conditions: Humana.
| 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 |
52443 appears in 16 coverage policies from Aetna, Capital Blue Cross, Premera Blue Cross, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Benign Prostatic Hyperplasia (0079) | covered if criteria are met | Apr 15, 2026 | payer document |
| Aetna | Benign Prostatic Hyperplasia (0079) | not covered | Apr 15, 2026 | payer document |
| Aetna | Bupivacaine Liposome (Exparel) (0941) | listed, no stance (range 50010-53899) | Jul 30, 2026 | payer document |
| Capital Blue Cross | Experimental and Investigational Procedures (MP 4.002) Procedure codes: Genitourinary | listed, no stance | Sep 1, 2026 | payer document |
| Premera Blue Cross | Non-covered Experimental/Investigational Services Page | 28 of 38 | ∞ | listed, no stance | Oct 1, 2026 | payer document |
| Regence | Devices for Treatment of Benign Prostatic Hyperplasia, Urethral Stricture, and Urethral Stenosis (Surgery 230) | listed, no stance | Dec 1, 2025 | payer document |
| UnitedHealthcare | Category III CPT Codes (MMP043.49) fluoroscopy, when performed | Policy titled | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Prostate Surgeries and Interventions (CS334.H) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Prostate Surgeries and Interventions (2026T0618P) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Prostate Surgeries and Interventions (for Indiana Only) (CS334IN.09) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Prostate Surgeries and Interventions (for Kansas Only) (CS334KS.02) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Prostate Surgeries and Interventions (for Kentucky Only) (CS334KY.12) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Prostate Surgeries and Interventions (for Nebraska Only) (CS334NE.I) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Prostate Surgeries and Interventions (for New Mexico Only) (CS334NM.D) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Prostate Surgeries and Interventions (for Ohio Only) (CS334OH.E) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Prostate Surgeries and Interventions (for Pennsylvania Only) (CS334PA.H) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Prostate Surgeries and Interventions (for Tennessee Only) (CS334TN.H) | listed, no stance | Jul 1, 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.