62331 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 62331

25 of 25 payer prior-auth lists that name 62331 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), CarePlus Health Plans, HealthSpring, Humana, Molina Healthcare of California, Molina Healthcare of Illinois, Molina Healthcare of Michigan, Molina Healthcare of New Mexico, Molina Healthcare of Texas, Passport by Molina Healthcare (Kentucky).

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)
Blue Cross Blue Shield of Arizona (AZ Blue)Federal Employee Program (FEP)AZprior auth requiredSep 1, 2026Federal Employee Program (FEP) Prior Authorization Requirements Code List (Updated 09/01/2026)
Blue Cross Blue Shield of Arizona (AZ Blue)Standard PA code list (most commercial plans)AZprior auth requiredGold-card eligibleSep 1, 2026AZ Blue Standard Prior Authorization Requirements Code List (09/01/2026)
Blue Cross Blue Shield of Arizona (AZ Blue)State of Arizona employee group (SYD, S3Z)AZprior auth requiredGold-card eligibleSep 1, 2026State of Arizona Group Prior Authorization Requirements Code List (09/01/2026)
Blue Cross Blue Shield of Arizona (AZ Blue)Teamsters group (TYW)AZprior auth requiredGold-card eligibleSep 1, 2026Teamsters Group Prior Authorization Requirements Code List (Updated 09/01/2026)
HealthSpringMedicare AdvantageAllprior auth requiredApr 1, 20262026 Q4 Prior Authorization List
CarePlus Health PlansCarePlus Health PlansFLprior auth requiredJan 1, 2027Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List
HumanaHumana D-SNP (FL)FLprior auth requiredJan 1, 20271 *New prior authorization requirement 787403FL0725 FLHMQSREN Humana Dual Fully Integrated Florida Prior Authorization and Notification List
HumanaHumana D-SNP (IL)ILprior auth requiredJan 1, 2027Humana Dual Fully Integrated Illinois Prior Authorization and Notification List
HumanaHumana D-SNP (IN)INprior auth requiredJan 1, 2027*New prior authorization requirement 814403IN0825 H4939_INHN6Z6EN_C Humana PathWays Dual Care (HMO-POS D-SNP) Indiana Prior Authorization and Notification List
HumanaHumana D-SNP (MI)MIprior auth requiredJan 1, 20271 Humana Dual Highly Integrated Michigan Prior Authorization and Notification List
HumanaHumana D-SNP (SC)SCprior auth requiredJan 1, 2027Humana Dual Highly Integrated South Carolina Prior Authorization and Notification List
HumanaHumana D-SNP (VA)VAprior auth requiredJan 1, 2027Virginia Prior Authorization and Notification List
HumanaHumana Healthy HorizonsILprior auth requiredJan 1, 2027Humana 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 .
HumanaHumana MA and D-SNPAllprior auth requiredJan 1, 2027Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List
HumanaMusculoskeletalAllprior auth requiredHumana Prior Authorization List (PAL): Musculoskeletal Services
HumanaMusculoskeletalAllprior auth requiredHumana Prior Authorization List (PAL): Musculoskeletal Services
HumanaMusculoskeletalAllprior auth requiredHumana Prior Authorization List (PAL): Musculoskeletal Services
Molina Healthcare of CaliforniaMedicaidCAprior auth requiredApr 1, 2026Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026
Molina Healthcare of IllinoisMedicaidILprior auth requiredJan 1, 2026Molina Healthcare of Illinois Codification Grid Q3 2026
Molina Healthcare of MichiganMedicare AdvantageMIprior auth requiredJul 1, 2026Molina Healthcare of Michigan PA Matrix 2026-Q3
Molina Healthcare of MichiganMedicaidMIprior auth requiredJul 1, 2026Molina Healthcare of Michigan PA Matrix 2026-Q3
Molina Healthcare of New MexicoMedicaidNMprior auth requiredAdd-on code to 62330Jan 1, 2026New Mexico Medicaid Prior Auth (PA) Code Matrix, effective July 1, 2026
Molina Healthcare of TexasSTAR, STAR+PLUS, STAR Kids, CHIP (Medicaid PA code matrix)TXprior auth requiredAdd-on code to 62330Jan 1, 2026Medicaid Behavioral Health and Medical Prior Authorization (PA) Code Matrix (Texas), 2026-Q3
Passport by Molina Healthcare (Kentucky)MedicaidKYprior auth requiredJul 1, 2026Kentucky Medicaid Prior Auth (PA) Code Matrix and Kentucky PA Code Exceptions, effective Q3 2026

Payer coverage policies that name 62331

62331 appears in 27 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Blue Shield of California, Centene, Premera Blue Cross, Regence, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
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
AetnaSpinal Surgery: Laminectomy and Fusion (0743)covered if criteria are metJul 30, 2026payer document
AetnaThermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703)listed, no stance (range 61000-64999)Nov 24, 2025payer document
AnthemPercutaneous Spinal Surgery (SURG.00071)unproven / investigationalMay 14, 2026payer document
Blue Cross & Blue Shield of MississippiAutomated Percutaneous And Percutaneous Endoscopic Discectomyunproven / investigationalpayer document
Blue Cross & Blue Shield of MississippiImageguided Minimally Invasive Decompression For Spinal Stenosis (A.7.01.126)unproven / investigationalpayer document
Blue Cross & Blue Shield of Rhode IslandMinimally Invasive Procedures for Back Paincovered if criteria are metAug 19, 2026payer document
Blue Cross & Blue Shield of Rhode IslandMinimally Invasive Procedures for Back Painnot coveredAug 19, 2026payer document
Blue Cross Blue Shield of MassachusettsDecompression of the Intervertebral Disc Using Laser Energy (271)unproven / investigationalpayer document
Blue Cross Blue Shield of MassachusettsImage-Guided Minimally Invasive Decompression for Spinal Stenosis (240)unproven / investigationalpayer document
Blue Cross NCAutomated Percutaneous and Endoscopic Discectomylisted, no stanceMay 1, 2026payer document
Blue Cross NCImage-Guided Minimally Invasive Decompression (IG-MLD) for Spinal Stenosislisted, no stanceMay 1, 2026payer document
Blue Shield of CaliforniaImage-Guided Minimally Invasive Decompression for Spinal Stenosis (7.01.126)listed, no stancepayer document
CenteneDisc Decompression Procedures (CP.MP.114)not coveredApr 1, 2026payer document
Premera Blue CrossImage-Guided Minimally Invasive Decompression for Spinal Stenosis (7.01.126)listed, no stanceJun 22, 2026payer document
RegenceImage-Guided Minimally Invasive Decompression (IG-MSD) for Spinal Stenosis (Surgery 176)listed, no stanceFeb 1, 2026payer document
UnitedHealthcareMinimally Invasive Spine Surgery Procedures (2026T0640H)listed, no stanceFeb 1, 2026payer document
UnitedHealthcareMinimally Invasive Spine Surgery Procedures (CS364.D)listed, no stanceMar 1, 2026payer document
UnitedHealthcareMinimally Invasive Spine Surgery Procedures (for Kansas Only) (CS364KS.02)listed, no stanceMar 1, 2026payer document
UnitedHealthcareMinimally Invasive Spine Surgery Procedures (for Kentucky Only) (CS364KY.04)listed, no stanceMar 1, 2026payer document
UnitedHealthcareMinimally Invasive Spine Surgery Procedures (for Nebraska Only) (CS364NE.D)listed, no stanceMar 1, 2026payer document
UnitedHealthcareMinimally Invasive Spine Surgery Procedures (for New Mexico Only) (CS364NM.C)listed, no stanceMar 1, 2026payer document
UnitedHealthcareMinimally Invasive Spine Surgery Procedures (for Ohio Only) (CS364OH.D)listed, no stanceApr 1, 2026payer document
UnitedHealthcareMinimally Invasive Spine Surgery Procedures (for Pennsylvania Only) (CS364PA.D)listed, no stanceMar 1, 2026payer document
UnitedHealthcareMinimally Invasive Spine Surgery Procedures (for Tennessee Only) (CS364TN.D)listed, no stanceMar 1, 2026payer document

Recent prior-auth changes

  • Jul 1, 2026: PA added, Molina Healthcare of Texas
  • Apr 1, 2026: PA added, HealthSpring
  • Jan 1, 2026: PA added, Molina Healthcare of Michigan
  • Jan 1, 2026: PA added, Passport by Molina Healthcare (Kentucky)
  • Jan 1, 2026: PA added, Molina Healthcare of Illinois
  • Jan 1, 2026: PA added, Molina Healthcare of Michigan

Medicaid fee-for-service

Prior authorization required or conditional in IN, WA.

  • AZ: $194.56 (physician, AHCCCS PT 08, facility), effective Jan 1, 2026
  • IL: $135.24 (practitioner), effective Jan 1, 2026
  • MS: $162.86 (comprehensive), effective Jul 1, 2026
  • ND: $203.89 (physician), effective Aug 1, 2026
  • NY: $100.69 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $148.93 (code_changes), effective Jan 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $110.46 (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.