62291 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 62291

4 of 4 payer prior-auth lists that name 62291 require prior authorization or set conditions: UnitedHealthcare, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
UnitedHealthcareUnitedHealthcare Complete (Individual & Family plans)Allprior auth requiredSep 1, 2026Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026
UnitedHealthcareUnitedHealthcare Individual Exchange plansAllprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHealthcare Individual Exchange plans Effective October 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Community Plan of KentuckyKYprior auth requiredJul 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Kentucky Effective July 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Connected (Texas MMP)TXprior auth requiredJan 1, 2015Prior authorization requirements for UnitedHealthcare Connected (Medicare-Medicaid Plan) Texas Effective November 1, 2025 This list contains prior authorization review requirements for participating U

Payer coverage policies that name 62291

62291 appears in 20 coverage policies from Aetna, Anthem, Centene, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaDiscography (0733)not coveredJun 17, 2025payer 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
AnthemCervical and Thoracic Discography (RAD.00053)unproven / investigationalNov 6, 2025payer document
CenteneDiscography (CP.MP.115)covered if criteria are metApr 1, 2026payer document
UnitedHealthcareEpiduroscopy, Epidural Lysis of Adhesions, and Discography (2026T0206DD)listed, no stanceJan 1, 2026payer document
UnitedHealthcareEpiduroscopy, Epidural Lysis of Adhesions, and Discography (CS040.P)listed, no stanceFeb 1, 2026payer document
UnitedHealthcareEpiduroscopy, Epidural Lysis of Adhesions, and Discography (for Idaho Only) (CS040ID.B)listed, no stanceJun 1, 2026payer document
UnitedHealthcareEpiduroscopy, Epidural Lysis of Adhesions, and Discography (for Kansas Only) (CS040KS.03)listed, no stanceSep 1, 2026payer document
UnitedHealthcareEpiduroscopy, Epidural Lysis of Adhesions, and Discography (for Kentucky Only) (CS040KY.13)listed, no stanceAug 1, 2026payer document
UnitedHealthcareEpiduroscopy, Epidural Lysis of Adhesions, and Discography (for Nebraska Only) (CS040NE.P)listed, no stanceFeb 1, 2026payer document
UnitedHealthcareEpiduroscopy, Epidural Lysis of Adhesions, and Discography (for New Jersey Only) (CS040NJ.L)listed, no stanceFeb 1, 2026payer document
UnitedHealthcareEpiduroscopy, Epidural Lysis of Adhesions, and Discography (for New Mexico Only) (CS040NM.C)listed, no stanceFeb 1, 2026payer document
UnitedHealthcareEpiduroscopy, Epidural Lysis of Adhesions, and Discography (for North Carolina Only) (CSNCT0206.05)listed, no stanceFeb 1, 2026payer document
UnitedHealthcareEpiduroscopy, Epidural Lysis of Adhesions, and Discography (for Ohio Only) (CS040OH.D)listed, no stanceAug 1, 2026payer document
UnitedHealthcareEpiduroscopy, Epidural Lysis of Adhesions, and Discography (for Pennsylvania Only) (CS040PA.O)listed, no stanceMar 1, 2026payer document
UnitedHealthcareEpiduroscopy, Epidural Lysis of Adhesions, and Discography (for Tennessee Only) (CS040TN.N)listed, no stanceFeb 1, 2026payer document

Recent prior-auth changes

  • Apr 1, 2026: PA removed, UnitedHealthcare Community Plan
  • Jan 1, 2025: PA removed, UnitedHealthcare

Medicaid fee-for-service

Prior authorization required or conditional in WA.

  • AZ: $164.57 (outpatient_hospital, RF133), effective Oct 1, 2025
  • CO: $187.43 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $103.91 (physician, facility), effective Jan 1, 2026
  • IL: $138.09 (practitioner), effective Apr 1, 2024
  • IN: $111.09 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $100.00 (asc, facility), effective Aug 1, 1982
  • KY: $0.00 (asc), effective Jan 1, 2026
  • LA: $241.06 (professional), effective Jul 1, 2025
  • MA: $0.00 (asc), effective May 1, 2026
  • MS: $114.52 (comprehensive), effective Jul 1, 2026
  • ND: $373.99 (physician), effective Aug 1, 2026
  • NE: $122.04 (physician, facility), effective Jul 1, 2026
  • NY: $78.67 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $128.72 (physician, facility), effective Dec 31, 2013
  • OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026
  • TX: $112.80 (physician, Physician, facility), effective Mar 1, 2025
  • VA: $115.74 (medical, facility), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $78.54 (physician, facility), effective Jul 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.