69719 CPT® code: payer coverage and prior authorization11 of 12 payer prior-auth lists that name 69719 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Molina Complete Care (Virginia), Molina Healthcare of Arizona, Molina Healthcare of Iowa, Molina Healthcare of Nevada, Molina Healthcare of Ohio, Molina Healthcare of Texas, Rocky Mountain Health Plans.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross Blue Shield of Arizona (AZ Blue) | State of Arizona employee group (SYD, S3Z) | AZ | prior auth required | Sep 1, 2026 | State of Arizona Group Prior Authorization Requirements Code List (09/01/2026) | |
| Molina Complete Care (Virginia) | Medicare-only PA matrix for D-SNP | VA | prior auth required | Jan 1, 2022 | Medicare Prior Auth (PA) Code Matrix (Virginia), effective Q1 2022 | |
| Molina Healthcare of Arizona | Medicare-only PA matrix for D-SNP | AZ | prior auth required | Jan 1, 2022 | Medicare Prior Auth (PA) Code Matrix (Arizona), effective Q1 2022 | |
| Molina Healthcare of Iowa | Medicaid | IA | prior auth required | Jul 1, 2023 | IA Prior Authorization Matrix, effective Q3 2023 | |
| Molina Healthcare of Nevada | Medicaid | NV | prior auth required | Oct 1, 2022 | Medicaid Prior Auth (PA) Code Matrix, effective Q4 2022 | |
| Molina Healthcare of Ohio | Medicaid and MyCare Ohio (MMP) Medicaid | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Ohio | Medicare and MyCare Ohio (MMP) Medicare | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Ohio | Exchange | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of Texas | Exchange | TX | prior auth required | Jan 1, 2022 | Marketplace Prior Authorization (PA) Code Matrix (Texas), effective July 1, 2026 | |
| Rocky Mountain Health Plans | Rocky Mountain Health Plans CHP+ | CO | prior auth required | Oct 1, 2026 | Rocky Mountain Children’s Health Plan - prior authorization Effective October 1, 2026 | |
| 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 |
69719 appears in 25 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.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Bone-Anchored Hearing Aids (0403) | covered if criteria are met | Jul 22, 2026 | payer document |
| Aetna | Cochlear Implants and Auditory Brainstem Implants (0013) | listed, no stance | Aug 18, 2026 | payer document |
| Aetna | Myringotomy and Tympanostomy Tube (0418) | listed, no stance (range 69420-69799) | Jun 30, 2026 | payer document |
| Anthem | Bone-Anchored and Bone Conduction Hearing Aids (CG-SURG-82) | covered if criteria are met | May 14, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Implantable Boneconduction And Boneanchored Hearing Aids | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Implantable Bone- Conduction and Bone-Anchored Hearing Aids | covered if criteria are met | Apr 16, 2025 | payer document |
| Blue Cross Blue Shield of Massachusetts | Implantable Bone-Conduction and Bone-Anchored Hearing A (479) | listed, no stance | payer document | |
| Blue Cross NC | Implantable Bone Conduction Hearing Aids | listed, no stance | Feb 1, 2026 | payer document |
| Blue Shield of California | Implantable Bone-Conduction and Bone-Anchored Hearing Aids (7.01.03) | listed, no stance | payer document | |
| Centene | Bone-Anchored Hearing Aid (CP.MP.93) | covered if criteria are met | May 1, 2026 | payer document |
| Premera Blue Cross | Implantable Bone-Conduction and Bone-Anchored Hearing Aids (7.01.547) Page | 5 of 26 | ∞ | listed, no stance | Apr 13, 2026 | payer document |
| Regence | Transcutaneous Bone-Conduction and Bone-Anchored Hearing Aids (Surgery 121) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Kansas Only) (CS052KS.04) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Nebraska Only) (CS052NE.V) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for New Jersey Only) (CS052NJ.S) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Tennessee Only) (CS052TN.T) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (2026T0396II) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Mar 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (CS052.V) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Idaho Only) (CS052ID.D) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Louisiana Only) (CS052LA.O) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Aug 1, 2025 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for New Mexico Only) (CS052NM.D) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for North Carolina Only) (CSNCT0396.10) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Ohio Only) (CS052OH.F) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Pennsylvania Only) (CS052PA.S) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Instruments and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Kentucky Only) (CS052KY.13) Bone Anchored Hearing Aids (BAHA) | listed, no stance | Aug 1, 2026 | payer document |
Prior authorization required or conditional in ND, NE, VA, WA.
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.