66174 CPT® code: payer coverage and prior authorization4 of 4 payer prior-auth lists that name 66174 require prior authorization or set conditions: Cigna.
| 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, 2011 | 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, 2011 | Master Precertification List (For Health Care Providers) |
| Cigna | Other Services | All | prior auth required | Mar 7, 2026 | Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs | |
| Cigna | Other Services | All | prior auth required | Mar 7, 2026 | Cigna Commercial Prior Authorization Procedure Code List: Other Services |
66174 appears in 21 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, BlueCross BlueShield of South Carolina, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Glaucoma Surgery (0484) | covered if criteria are met | Jul 14, 2026 | payer document |
| Anthem | Canaloplasty (CG-SURG-125) | covered if criteria are met | Nov 6, 2025 | payer document |
| Blue Cross & Blue Shield of Mississippi | Viscocanalostomy And Canaloplasty | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Viscocanalostomy and Canaloplasty sad | covered if criteria are met | Apr 1, 2026 | payer document |
| Blue Cross Blue Shield of Massachusetts | Viscocanalostomy and Canaloplasty (372) | listed, no stance | payer document | |
| Blue Cross NC | Viscocanalostomy and Canaloplasty | listed, no stance | Jun 1, 2026 | payer document |
| BlueCross BlueShield of South Carolina | Viscocanalostomy and Canaloplasty (CAM 90326) | listed, no stance | May 1, 2026 | payer document |
| Cigna | Glaucoma Surgical Procedures (0035) | covered if criteria are met | Apr 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Viscocanalostomy and Canaloplasty (SUR713.032) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Glaucoma Surgical Treatments (2026T0443MM) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Glaucoma Surgical Treatments (CS050.Y) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Glaucoma Surgical Treatments (for Idaho Only) (CS050ID.C) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Glaucoma Surgical Treatments (for Kansas Only) (CS050KS.03) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Glaucoma Surgical Treatments (for Kentucky Only) (CS050KY.09) | listed, no stance | Mar 1, 2026 | payer document |
| UnitedHealthcare | Glaucoma Surgical Treatments (for Nebraska Only) (CS050NE.Y) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Glaucoma Surgical Treatments (for New Jersey Only) (CS050NJ.V) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Glaucoma Surgical Treatments (for New Mexico Only) (CS050NM.E) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Glaucoma Surgical Treatments (for North Carolina Only) (CSNCT0443.04) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Glaucoma Surgical Treatments (for Ohio Only) (CS050OH.D) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Glaucoma Surgical Treatments (for Pennsylvania Only) (CS050PA.V) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Glaucoma Surgical Treatments (for Tennessee Only) (CS050TN.V) | listed, no stance | Feb 1, 2026 | payer document |
Prior authorization required or conditional in IN.
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.