Payer policies › CPT 6189261892 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 61892 11 of 11 payer prior-auth lists that name 61892 require prior authorization or set conditions: CarePlus Health Plans, Humana.
Payer Plan State Prior auth Conditions Since Source CarePlus Health Plans CarePlus Health Plans FL prior auth required Jan 1, 2027 Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List Humana Humana D-SNP (FL) FL prior auth required Jan 1, 2027 1 *New prior authorization requirement 787403FL0725 FLHMQSREN Humana Dual Fully Integrated Florida Prior Authorization and Notification List Humana Humana D-SNP (IL) IL prior auth required Jan 1, 2027 Humana Dual Fully Integrated Illinois Prior Authorization and Notification List Humana Humana D-SNP (IN) IN prior auth required Jan 1, 2027 *New prior authorization requirement 814403IN0825 H4939_INHN6Z6EN_C Humana PathWays Dual Care (HMO-POS D-SNP) Indiana Prior Authorization and Notification List Humana Humana D-SNP (MI) MI prior auth required Jan 1, 2027 1 Humana Dual Highly Integrated Michigan Prior Authorization and Notification List Humana Humana D-SNP (SC) SC prior auth required Jan 1, 2027 Humana Dual Highly Integrated South Carolina Prior Authorization and Notification List Humana Humana D-SNP (VA) VA prior auth required Jan 1, 2027 Virginia Prior Authorization and Notification List Humana Humana Healthy Horizons IL prior auth required Jan 1, 2027 Humana Healthy Horizons in Illinois Prior Authorization and Notification List To view -specific medical coverage policies, please visit Humana Healthy Horizons in Illinois Clinical coverage policies . Humana Humana Healthy Horizons VA prior auth required Jan 1, 2027 Humana Healthy Horizons in Virginia Prior Authorization and Notification List (PAL) Humana Humana MA and D-SNP All prior auth required Jan 1, 2027 Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List Humana Oak Street Health All prior auth required Oak Street Health (Humana): Prior Authorization List (PAL) Codes Under Management
Payer coverage policies that name 61892 61892 appears in 5 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).
Payer Policy Role in policy Reviewed Document Aetna Intravenous Iron Therapy (0575) listed, no stance (range 61000-64999) Jul 1, 2026 payer document Aetna Respiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479) listed, no stance (range 61000-64999) Jul 9, 2026 payer document Aetna Thermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703) listed, no stance (range 61000-64999) Nov 24, 2025 payer document Blue Cross & Blue Shield of Mississippi Responsive Neurostimulation For The Treatment Of Refractory Focal Epilepsy (A.7.01.143) listed, no stance payer document Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) Responsive Neurostimulation for the Treatment of Refractory Focal Epilepsy (SUR712.039)CPT Codes 61850, 61860, 61863, 61864, 61880, 61885, 61886, 61888, 61889, listed, no stance Dec 1, 2025 payer document
Recent prior-auth changes Jan 1, 2024: PA added, humana:pa:commercial Medicaid fee-for-service Prior authorization required or conditional in VA.
AZ: $1062.88 (asc), effective Oct 1, 2026 CO: $657.57 (health_first_colorado), effective Jul 1, 2026 IL: $581.81 (practitioner), effective Jan 1, 2024 IN: $645.00 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $541.32 (default), effective Aug 1, 2024 KY: $702.22 (physician, facility), effective Jan 1, 2026 LA: $701.59 (professional), effective Jan 1, 2024 MA: $618.17 (physician_surgery), effective May 1, 2024 MS: $887.99 (comprehensive), effective Jul 1, 2026 ND: $946.52 (physician, facility), effective Aug 1, 2026 NY: $702.09 (physician_surgery, facility), effective Jul 1, 2026 OH: $632.20 (physician), effective Jan 1, 2024 OK: $943.18 (physician, non-facility), effective Jul 1, 2026 VA: $949.65 (medical, facility), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WY: $1447.00 (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.