69711 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 69711

5 of 5 payer prior-auth lists that name 69711 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Rocky Mountain Health Plans, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross Blue Shield of Arizona (AZ Blue)State of Arizona employee group (SYD, S3Z)AZprior auth requiredSep 1, 2026State of Arizona Group Prior Authorization Requirements Code List (09/01/2026)
Rocky Mountain Health PlansRocky Mountain Health Plans CHP+COprior auth requiredOct 1, 2026Rocky Mountain Children’s Health Plan - prior authorization Effective October 1, 2026
Rocky Mountain Health PlansRocky Mountain Medicare Advantage D-SNPCOprior auth requiredFeb 1, 2025Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025
UnitedHealthcare Community PlanMaryland HealthChoiceMDprior auth requiredSep 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Maryland Effective September 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Connected (Texas MMP)TXprior auth requiredJan 1, 2023Prior 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 69711

69711 appears in 8 coverage policies from Aetna, Blue Cross & Blue Shield of Rhode Island, Blue Cross NC, Centene, Premera Blue Cross, Regence.

PayerPolicyRole in policyReviewedDocument
AetnaBone-Anchored Hearing Aids (0403)covered if criteria are metJul 22, 2026payer document
AetnaIntraoperative Neurophysiological Monitoring (0697)covered if criteria are metJun 19, 2026payer document
AetnaMyringotomy and Tympanostomy Tube (0418)listed, no stance (range 69420-69799)Jun 30, 2026payer document
Blue Cross & Blue Shield of Rhode IslandImplantable Bone- Conduction and Bone-Anchored Hearing Aidscovered if criteria are metApr 16, 2025payer document
Blue Cross NCImplantable Bone Conduction Hearing Aidslisted, no stanceFeb 1, 2026payer document
CenteneBone-Anchored Hearing Aid (CP.MP.93)covered if criteria are metMay 1, 2026payer document
Premera Blue CrossImplantable Bone-Conduction and Bone-Anchored Hearing Aids (7.01.547)listed, no stanceApr 13, 2026payer document
RegenceTranscutaneous Bone-Conduction and Bone-Anchored Hearing Aids (Surgery 121)listed, no stanceApr 1, 2026payer document

Recent prior-auth changes

  • Jul 1, 2026: PA removed, Humana
  • Mar 1, 2026: PA removed, Humana

Medicaid fee-for-service

Prior authorization required or conditional in FL, VA, WA.

  • AZ: $926.87 (asc), effective Oct 1, 2026
  • CO: $684.43 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $583.19 (physician, non-facility), effective Jan 1, 2026
  • IL: $567.16 (practitioner), effective Apr 1, 2024
  • IN: $641.57 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $658.89 (default), effective Aug 1, 2024
  • KY: $1445.19 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $896.80 (asc), effective May 1, 2026
  • MS: $1115.56 (comprehensive, facility), effective Oct 1, 2025
  • ND: $851.94 (physician, facility), effective Aug 1, 2026
  • NE: $1233.00 (asc), effective Jul 1, 2024
  • OH: $535.57 (physician), effective Jan 1, 2024
  • TX: $886.62 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $649.60 (medical), effective Jul 1, 2026
  • VT: $2574.33 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), effective Jul 1, 2026
  • WY: $1466.22 (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.