58563 CPT® code: payer coverage and prior authorization22 of 22 payer prior-auth lists that name 58563 require prior authorization or set conditions: Humana, Neighborhood Health Partnership, UnitedHealthcare, UnitedHealthcare Community Plan.
58563 appears in 28 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Centene, Cigna, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Acupuncture and Dry Needling (0135) | listed, no stance (range 56405-58999) | Mar 25, 2026 | payer document |
| Aetna | Bupivacaine Liposome (Exparel) (0941) | listed, no stance (range 58541-58575) | Jul 30, 2026 | payer document |
| Aetna | Cryoablation (0100) | listed, no stance | Aug 4, 2026 | payer document |
| Aetna | Endometrial Ablation (0091) | covered if criteria are met | Mar 25, 2026 | payer document |
| Aetna | Gonadotropin-Releasing Hormone Analogs and Antagonists (0501) | listed, no stance | Jul 10, 2026 | payer document |
| Aetna | Infertility (0327) | covered if criteria are met | Jul 16, 2026 | payer document |
| Aetna | Premenstrual Syndrome and Premenstrual Dysphoric Disorder (0512) Vestibular stimulation, plasma leptin, measurement of serum trace elements, allopregnanolone antagonist, aromatherapy, measurement of serum melatonin levels | not covered | Aug 5, 2026 | payer document |
| Aetna | Recurrent Pregnancy Loss (0348) | covered if criteria are met (range 58555-58563) | Jun 23, 2026 | payer document |
| Aetna | Urological Supplies (0533) | listed, no stance (range 56405-58999) | Jul 30, 2026 | payer document |
| Anthem | Endometrial Ablation (CG-SURG-15) | covered if criteria are met | Aug 13, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Endometrial Ablation (L.4.01.403) | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Endometrial Ablation | covered if criteria are met | Jan 7, 2026 | payer document |
| Centene | Endometrial Ablation (CP.MP.106) | covered if criteria are met | Aug 1, 2023 | payer document |
| Cigna | Endometrial Ablation (0013) | covered if criteria are met | Feb 15, 2026 | payer document |
| Regence | Endometrial Ablation (Surgery 01) | listed, no stance | Dec 1, 2025 | payer document |
| Regence | Gender Affirming Interventions for Gender Dysphoria (Medicine 153) NOTES | listed, no stance | Nov 1, 2025 | payer document |
| UnitedHealthcare | Abnormal Uterine Bleeding and Uterine Fibroids (2026T0442VV) Uterine Fibroids | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Abnormal Uterine Bleeding and Uterine Fibroids (CS002.AG) Uterine Fibroids | listed, no stance | Nov 1, 2025 | payer document |
| UnitedHealthcare | Abnormal Uterine Bleeding and Uterine Fibroids (for Idaho Only) (CS002ID.C) Uterine Fibroids | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Abnormal Uterine Bleeding and Uterine Fibroids (for Kansas Only) (CS002KS.02) Uterine Fibroids | listed, no stance | Nov 1, 2025 | payer document |
| UnitedHealthcare | Abnormal Uterine Bleeding and Uterine Fibroids (for Kentucky Only) (CS002KY.10) Uterine Fibroids | listed, no stance | Nov 1, 2025 | payer document |
| UnitedHealthcare | Abnormal Uterine Bleeding and Uterine Fibroids (for Nebraska Only) (CS002NE.AG) Uterine Fibroids | listed, no stance | Dec 1, 2025 | payer document |
| UnitedHealthcare | Abnormal Uterine Bleeding and Uterine Fibroids (for New Jersey Only) (CS002NJ.AE) Uterine Fibroids | listed, no stance | Nov 1, 2025 | payer document |
| UnitedHealthcare | Abnormal Uterine Bleeding and Uterine Fibroids (for New Mexico Only) (CS002NM.C) Uterine Fibroids | listed, no stance | Nov 1, 2025 | payer document |
| UnitedHealthcare | Abnormal Uterine Bleeding and Uterine Fibroids (for North Carolina Only) (CSNCT0442.06) Uterine Fibroids | listed, no stance | Nov 1, 2025 | payer document |
| UnitedHealthcare | Abnormal Uterine Bleeding and Uterine Fibroids (for Ohio Only) (CS002OH.D) Uterine Fibroids | listed, no stance | Dec 1, 2025 | payer document |
| UnitedHealthcare | Abnormal Uterine Bleeding and Uterine Fibroids (for Pennsylvania Only) (CS002PA.AE) Uterine Fibroids | listed, no stance | Dec 1, 2025 | payer document |
| UnitedHealthcare | Abnormal Uterine Bleeding and Uterine Fibroids (for Tennessee Only) (CS002TN.AF) Uterine Fibroids | listed, no stance | Nov 1, 2025 | 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.