69730 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 69730

24 of 24 payer prior-auth lists that name 69730 require prior authorization or set conditions: Molina Complete Care (Virginia), Molina Healthcare of California, Molina Healthcare of Idaho, Molina Healthcare of Illinois, Molina Healthcare of Iowa, Molina Healthcare of Michigan, Molina Healthcare of Mississippi, Molina Healthcare of New Mexico, Molina Healthcare of Ohio, Molina Healthcare of Texas, Molina Healthcare of Utah, Passport by Molina Healthcare (Kentucky), Rocky Mountain Health Plans, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
Molina Complete Care (Virginia)MedicaidVAprior auth requiredApr 1, 2025Virginia Medicaid PA Code Matrix and Virginia code/benefit exceptions, effective Q2 2025
Molina Healthcare of CaliforniaMedicaidCAprior auth requiredApr 1, 2026Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026
Molina Healthcare of IdahoMedicaidIDprior auth requiredJan 1, 2025Idaho Medicaid Prior Auth (PA) Code Matrix and Idaho code/benefit exceptions, Q1 2025
Molina Healthcare of IllinoisMedicaidILprior auth requiredJan 1, 2022Molina Healthcare of Illinois Codification Grid Q3 2026
Molina Healthcare of IowaMedicaidIAprior auth requiredJul 1, 2023IA Prior Authorization Matrix, effective Q3 2023
Molina Healthcare of MichiganMedicaidMIprior auth requiredJul 1, 2026Molina Healthcare of Michigan PA Matrix 2026-Q3
Molina Healthcare of MississippiMedicaidMSprior auth requiredJan 1, 2025Mississippi Medicaid Prior Auth (PA) Code Matrix and exceptions, effective Q1 2025
Molina Healthcare of New MexicoMedicaidNMprior auth requiredJul 1, 2026New Mexico Medicaid Prior Auth (PA) Code Matrix, effective July 1, 2026
Molina Healthcare of OhioMedicaid and MyCare Ohio (MMP) MedicaidOHprior auth requiredOct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of OhioMedicare and MyCare Ohio (MMP) MedicareOHprior auth requiredOct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of OhioExchangeOHprior auth requiredOct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of TexasSTARTXprior auth requiredFeb 19, 2025Molina Healthcare of Texas Prior Authorization Annual Review Report (STAR), reviewed 2025-02-19
Molina Healthcare of TexasSTAR+PLUSTXprior auth requiredFeb 19, 2025Molina Healthcare of Texas Prior Authorization Annual Review Report (STAR+PLUS), reviewed 2025-02-19
Molina Healthcare of TexasSTAR, STAR+PLUS, STAR Kids, CHIP (Medicaid PA code matrix)TXprior auth requiredJan 1, 2023Medicaid Behavioral Health and Medical Prior Authorization (PA) Code Matrix (Texas), 2026-Q3
Molina Healthcare of TexasExchangeTXprior auth requiredJan 1, 2023Marketplace Prior Authorization (PA) Code Matrix (Texas), effective July 1, 2026
Molina Healthcare of UtahMedicaidUTprior auth requiredJan 1, 2025Utah Medicaid Prior Auth (PA) Code Matrix and Utah code/benefit exceptions, Q1 2025
Passport by Molina Healthcare (Kentucky)MedicaidKYprior auth requiredJul 1, 2026Kentucky Medicaid Prior Auth (PA) Code Matrix and Kentucky PA Code Exceptions, effective Q3 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 PlanTexas CHIPTXprior auth requiredSep 1, 2026Prior authorization requirements for Texas CHIP Effective September 1, 2026 This list contains prior authorization requirements for participating UnitedHealthcare Community Plan Texas CHIP health care
UnitedHealthcare Community PlanTexas STARTXprior auth requiredMar 1, 2023Prior authorization requirements for Texas STAR Effective September 1, 2026 This list contains prior authorization review requirements for participating UnitedHealthcare Community Plan of Texas STAR h
UnitedHealthcare Community PlanTexas STAR KidsTXprior auth requiredMar 1, 2023Prior authorization requirements for STAR Kids Effective September 1, 2026 This list contains prior authorization review requirements for participating UnitedHealthcare Community Plan of Texas STAR Ki
UnitedHealthcare Community PlanTexas STAR+PLUSTXprior auth requiredMar 1, 2023Prior authorization requirements for STAR+Plus Effective September 1, 2026 This list contains prior authorization requirements for participating UnitedHealthcare Community Plan STAR+PLUS health care p
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 69730

69730 appears in 27 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, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaBone-Anchored Hearing Aids (0403)covered if criteria are metJul 22, 2026payer document
AetnaCochlear Implants and Auditory Brainstem Implants (0013)covered if criteria are metAug 18, 2026payer document
AetnaGrid Monitoring and Intraoperative Electroencephalography (0289)listed, no stance (range 69720-69745)Apr 17, 2026payer document
AetnaIntraoperative Neurophysiological Monitoring (0697)covered if criteria are met (range 69720-69745)Jun 19, 2026payer document
AetnaMyringotomy and Tympanostomy Tube (0418)listed, no stance (range 69420-69799)Jun 30, 2026payer document
AnthemBone-Anchored and Bone Conduction Hearing Aids (CG-SURG-82)covered if criteria are metMay 14, 2026payer document
Blue Cross & Blue Shield of MississippiImplantable Boneconduction And Boneanchored Hearing Aidscovered if criteria are metpayer document
Blue Cross & Blue Shield of Rhode IslandImplantable Bone- Conduction and Bone-Anchored Hearing Aidscovered if criteria are metApr 16, 2025payer document
Blue Cross Blue Shield of MassachusettsImplantable Bone-Conduction and Bone-Anchored Hearing A (479)listed, no stancepayer document
Blue Cross NCImplantable Bone Conduction Hearing Aidslisted, no stanceFeb 1, 2026payer document
Blue Shield of CaliforniaImplantable Bone-Conduction and Bone-Anchored Hearing Aids (7.01.03)listed, no stancepayer document
CenteneBone-Anchored Hearing Aid (CP.MP.93)covered if criteria are metMay 1, 2026payer document
CenteneBone-Anchored Hearing Aid (CP.MP.93)not coveredMay 1, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Implantable Bone-Conduction and Bone-Anchored Hearing Aids (SUR714.003)
CPT Codes 69710, 69711, 69714, 69716, 69717, 69719, 69726, 69727, 69728,
listed, no stanceOct 1, 2026payer document
Premera Blue CrossImplantable Bone-Conduction and Bone-Anchored Hearing Aids (7.01.547)
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listed, no stanceApr 13, 2026payer document
RegenceTranscutaneous Bone-Conduction and Bone-Anchored Hearing Aids (Surgery 121)listed, no stanceApr 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Kansas Only) (CS052KS.04)
Bone Anchored Hearing Aids (BAHA)
listed, no stanceSep 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Nebraska Only) (CS052NE.V)
Bone Anchored Hearing Aids (BAHA)
listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for New Jersey Only) (CS052NJ.S)
Bone Anchored Hearing Aids (BAHA)
listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Tennessee Only) (CS052TN.T)
Bone Anchored Hearing Aids (BAHA)
listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (2026T0396II)
Bone Anchored Hearing Aids (BAHA)
listed, no stanceMar 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (CS052.V)
Bone Anchored Hearing Aids (BAHA)
listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Idaho Only) (CS052ID.D)
Bone Anchored Hearing Aids (BAHA)
listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Louisiana Only) (CS052LA.O)
Bone Anchored Hearing Aids (BAHA)
listed, no stanceAug 1, 2025payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for New Mexico Only) (CS052NM.D)
Bone Anchored Hearing Aids (BAHA)
listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Ohio Only) (CS052OH.F)
Bone Anchored Hearing Aids (BAHA)
listed, no stanceSep 1, 2026payer document
UnitedHealthcareHearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Pennsylvania Only) (CS052PA.S)
Bone Anchored Hearing Aids (BAHA)
listed, no stanceJun 1, 2026payer document
UnitedHealthcareHearing Instruments and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Kentucky Only) (CS052KY.13)
Bone Anchored Hearing Aids (BAHA)
listed, no stanceAug 1, 2026payer document

Recent prior-auth changes

  • Feb 19, 2025: PA added, Molina Healthcare of Texas
  • Feb 19, 2025: PA added, Molina Healthcare of Texas
  • Jul 1, 2024: PA added, Molina Healthcare of Michigan
  • Feb 1, 2024: PA removed, Blue Shield of California Promise Health Plan
  • Feb 15, 2023: PA added, Blue Shield of California Promise Health Plan
  • Jan 1, 2023: PA added, Molina Healthcare of Texas
  • Jan 1, 2023: PA added, Molina Healthcare of Ohio

Medicaid fee-for-service

Prior authorization required or conditional in LA, ND, NE, VA, WA.

  • AZ: $8459.99 (asc), effective Oct 1, 2026
  • CO: $565.09 (health_first_colorado), effective Jul 1, 2026
  • FL: $283.87 (physician, non-facility), effective Jan 1, 2026
  • IL: $477.93 (practitioner), effective Apr 1, 2024
  • IN: $528.30 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $4920.32 (asc, facility), effective Jan 1, 2023
  • KY: $9994.11 (asc), effective Jan 1, 2026
  • LA: $602.46 (professional), effective Jan 1, 2023
  • MA: $7029.64 (asc), effective May 1, 2026
  • MS: $7471.33 (comprehensive, facility), effective Oct 1, 2025
  • ND: $5891.54 (physician, facility), effective Aug 1, 2026
  • NE: $985.52 (physician, non-facility), effective Jul 1, 2026
  • NY: $381.56 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $527.71 (physician), effective Jan 1, 2023
  • OK: $11561.30 (outpatient_hospital_apc), effective Jan 1, 2026
  • TX: $6263.30 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jan 1, 2023
  • VA: $518.23 (medical, facility), effective Jul 1, 2026
  • VT: $9968.74 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $353.54 (physician, facility), effective Jul 1, 2026
  • WY: $5677.74 (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.