57282 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 57282

5 of 5 payer prior-auth lists that name 57282 require prior authorization or set conditions: Humana, Neighborhood Health Partnership, UnitedHealthcare, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
HumanaHumana Puerto Rico MA and Dual Medicare-MedicaidPRprior auth requiredNov 3, 2025Puerto 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 PartnershipNeighborhood Health PartnershipFLprior auth under conditionssite of care: outpatient hospital; not in AK, IL, GU, MA, PR, RI, TX, UT, VI, WISep 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
UnitedHealthcare Community PlanMaryland HealthChoiceMDprior auth under conditionsonly with dx F64.0, F64.1, F64.2, F64.8, F64.9, Z87.890Sep 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Maryland Effective September 1, 2026
UnitedHealthcare Community PlanNorth Carolina MedicaidNCprior auth under conditionssite of care: outpatient hospital, ASCOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of North Carolina Effective October 1, 2026 July 1, 2024

Payer coverage policies that name 57282

57282 appears in 4 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaAcupuncture and Dry Needling (0135)listed, no stance (range 56405-58999)Mar 25, 2026payer document
AetnaGender Affirming Surgery (0615)covered if criteria are metSep 8, 2026payer document
AetnaOrgan Prolapse: Selected Procedures (0858)
Laparoscopic suture rectopexy, Dynamic magnetic resonance imaging (MRI)
covered if criteria are metDec 24, 2025payer document
AetnaUrological Supplies (0533)listed, no stance (range 56405-58999)Jul 30, 2026payer document

Recent prior-auth changes

  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, Oxford Health Plans
  • Aug 1, 2026: conditions changed, UnitedHealthcare
  • Jul 1, 2026: conditions changed, UnitedHealthcare
  • Jul 1, 2026: conditions changed, UnitedHealthcare
  • Jul 1, 2026: conditions changed, UnitedHealthcare
  • Jul 1, 2026: conditions changed, Neighborhood Health Partnership
  • Jul 1, 2025: conditions changed, Neighborhood Health Partnership

Medicaid fee-for-service

  • AZ: $2542.43 (asc), effective Oct 1, 2026
  • CO: $554.85 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $478.50 (physician, non-facility), effective Jan 1, 2026
  • IL: $480.44 (practitioner), effective Apr 1, 2024
  • IN: $532.87 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $400.00 (asc, facility), effective Aug 1, 1982
  • KY: $3150.42 (asc), effective Jan 1, 2026
  • LA: $565.87 (professional), effective Jul 1, 2025
  • MA: $2419.10 (asc), effective May 1, 2026
  • MS: $2497.10 (comprehensive, facility), effective Oct 1, 2025
  • ND: $1857.17 (physician, facility), effective Aug 1, 2026
  • NE: $227.85 (physician, non-facility), effective Jul 1, 2026
  • NY: $247.08 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $360.41 (physician), effective Jan 1, 2024
  • OK: $6677.64 (outpatient_hospital_apc), effective Jan 1, 2026
  • TX: $82.19 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2026
  • VA: $624.66 (medical), effective Jul 1, 2026
  • VT: $5757.80 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $359.65 (physician, facility), effective Jul 1, 2026
  • WY: $3279.38 (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.