Payer policies › CPT 6955069550 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 69550 2 of 2 payer prior-auth lists that name 69550 require prior authorization or set conditions: Neighborhood Health Partnership, UnitedHealthcare.
Payer Plan State Prior auth Conditions Since Source Neighborhood Health Partnership Neighborhood Health Partnership FL prior auth under conditions site of care: outpatient hospital; not in AK, IL, GU, MA, PR, RI, TX, UT, VI, WI Sep 1, 2026 Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026 UnitedHealthcare UnitedHealthcare Complete (Individual & Family plans) All prior auth under conditions site of care: outpatient hospital Sep 1, 2026 Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026
Payer coverage policies that name 69550 69550 appears in 2 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Bone-Anchored Hearing Aids (0403) listed, no stance (range 69550-69554) Jul 22, 2026 payer document Aetna Myringotomy and Tympanostomy Tube (0418) listed, no stance (range 69420-69799) Jun 30, 2026 payer document
Recent prior-auth changes Oct 1, 2026: PA removed, Oxford Health Plans Oct 1, 2026: PA removed, UnitedHealthcare Community Plan Oct 1, 2026: PA removed, UnitedHealthcare Oct 1, 2026: PA removed, UnitedHealthcare Oct 1, 2026: PA removed, UnitedHealthcare Aug 1, 2026: conditions changed, UnitedHealthcare Jul 1, 2026: conditions changed, UnitedHealthcare Jul 1, 2026: conditions changed, UnitedHealthcare Jul 1, 2026: conditions changed, Neighborhood Health Partnership Jul 1, 2026: conditions changed, UnitedHealthcare Medicaid fee-for-service AZ: $1943.46 (asc), effective Oct 1, 2026 CO: $874.16 (chp_plus, non-facility), effective Jul 1, 2026 FL: $761.39 (physician, non-facility), effective Jan 1, 2026 IL: $709.25 (practitioner), effective Apr 1, 2024 IN: $813.99 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $300.00 (asc, facility), effective Aug 1, 1982 KY: $2953.46 (asc), effective Jan 1, 2026 LA: $233.58 (asc), effective Jul 1, 2012 MA: $1909.57 (asc), effective May 1, 2026 MS: $2333.88 (comprehensive, facility), effective Oct 1, 2025 ND: $1741.07 (physician, facility), effective Aug 1, 2026 NE: $1233.00 (asc), effective Jul 1, 2024 NY: $508.42 (physician_surgery, facility), effective Jul 1, 2026 OH: $662.71 (physician), effective Jan 1, 2024 OK: $2694.50 (asc), effective Jan 1, 2026 TX: $1954.22 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023 VA: $848.09 (medical), effective Jul 1, 2026 VT: $4596.52 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $366.60 (asc), effective Jul 1, 2026 WY: $2617.97 (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.