65785 CPT® code: payer coverage and prior authorization6 of 6 payer prior-auth lists that name 65785 require prior authorization or set conditions: Cigna, Rocky Mountain Health Plans.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Cigna | ACA/IFP | All | prior auth required | May be delegated to eviCore for some clients | Jan 1, 2016 | Master Precertification List (For Health Care Providers) |
| Cigna | Basic Standard | All | prior auth required | May be delegated to eviCore for some clients | Jan 1, 2016 | Master Precertification List (For Health Care Providers) |
| Cigna | Complete/PHS+/Preferred | All | prior auth required | May be delegated to eviCore for some clients | Jan 1, 2016 | Master Precertification List (For Health Care Providers) |
| Cigna | Other Services | All | prior auth required | Experimental/investigational | Mar 7, 2026 | Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs |
| Cigna | Other Services | All | prior auth required | Experimental/investigational | Mar 7, 2026 | Cigna Commercial Prior Authorization Procedure Code List: Other Services |
| Rocky Mountain Health Plans | Rocky Mountain Medicare Advantage D-SNP | CO | prior auth required | Feb 1, 2025 | Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025 |
65785 appears in 4 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Cigna.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Corneal Remodeling (0023) | covered if criteria are met | Oct 9, 2026 | payer document |
| Anthem | Refractive Surgery (CG-SURG-77) | covered if criteria are met | Nov 6, 2025 | payer document |
| Blue Cross & Blue Shield of Mississippi | Implantation Of Intrastromal Corneal Ring Segments (L.9.03.406) | covered if criteria are met | payer document | |
| Cigna | Corneal Remodeling for Refractive Errors (0141) | covered if criteria are met | Nov 15, 2025 | payer document |
| Cigna | Corneal Remodeling for Refractive Errors (0141) | unproven / investigational | Nov 15, 2025 | payer document |
Prior authorization required or conditional in IN, KY, VA.
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.