62280 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 62280

10 of 10 payer prior-auth lists that name 62280 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Texas, Cigna, HealthSpring, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross Blue Shield of Arizona (AZ Blue)AZ Blue-administered Medicare Advantage (M2K)AZprior auth requiredSep 1, 2026AZ Blue Medicare Advantage Prior Authorization Requirements Code List (Effective 09/01/2026)
CignaACA/IFPAllprior auth requiredMay be delegated to eviCore for some clientsJan 1, 2016Master Precertification List (For Health Care Providers)
CignaComplete/PHS+/PreferredAllprior auth requiredMay be delegated to eviCore for some clientsJan 1, 2016Master Precertification List (For Health Care Providers)
CignaMusculoskeletalAllprior auth requiredMar 7, 2026Cigna Commercial Prior Authorization Procedure Code List: Musculoskeletal - Interventional Pain Management
CignaMusculoskeletalAllprior auth requiredMar 7, 2026Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs
Blue Cross and Blue Shield of IllinoisBlue Cross Community Health Plans (BCCHP), Illinois MedicaidILprior auth requiredCarelon-managedAug 1, 2025Illinois Medicaid Prior Authorization Code List, Effective 10/1/2026
Blue Cross and Blue Shield of IllinoisBlue Cross Community MMAI (Medicare-Medicaid Alignment Initiative)ILprior auth requiredeviCore-managedJan 1, 2025Procedure Code List, Effective 1/1/2025
Blue Cross and Blue Shield of TexasTexas PA exemption (gold card), outpatient, fully insuredTXprior auth requiredGold-card exemption availableJul 1, 2026BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range)
HealthSpringMedicare AdvantageAllprior auth requiredJan 1, 20252026 Q4 Prior Authorization List
UnitedHealthcare Community PlanUnitedHealthcare Community Plan of KentuckyKYprior auth requiredJul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Kentucky Effective July 1, 2026

Payer coverage policies that name 62280

62280 appears in 7 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBack Pain - Invasive Procedures (0016)not coveredOct 6, 2026payer document
AetnaHeadaches: Invasive Procedures (0707)not coveredJul 23, 2026payer document
AetnaIntraoperative Neurophysiological Monitoring (0697)not covered (range 62263-63746)Jun 19, 2026payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 61000-64999)Jul 1, 2026payer document
AetnaNerve Blocks (0863)listed, no stance (range 62263-63746)Jul 23, 2026payer document
AetnaRespiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479)listed, no stance (range 61000-64999)Jul 9, 2026payer document
AetnaThermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703)listed, no stance (range 61000-64999)Nov 24, 2025payer document

Recent prior-auth changes

  • Jul 1, 2026: PA added, HealthSpring

Medicaid fee-for-service

  • AZ: $293.41 (asc), effective Oct 1, 2026
  • CO: $161.26 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $110.76 (physician, facility), effective Jan 1, 2026
  • IL: $154.47 (practitioner), effective Apr 1, 2024
  • IN: $124.47 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $100.00 (asc, facility), effective Aug 1, 1982
  • KY: $473.93 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $348.77 (asc), effective May 1, 2026
  • MS: $382.35 (comprehensive, facility), effective Oct 1, 2025
  • ND: $279.38 (physician, facility), effective Aug 1, 2026
  • NE: $413.00 (asc), effective Jul 1, 2024
  • NY: $73.30 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $88.96 (physician, facility), effective Jan 1, 2024
  • OK: $432.38 (asc), effective Jan 1, 2026
  • TX: $340.77 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $118.06 (medical, facility), effective Jul 1, 2026
  • VT: $686.76 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $391.15 (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.