69799 CPT® code: payer coverage and prior authorization29 of 30 payer prior-auth lists that name 69799 require prior authorization or set conditions: Cigna, Humana, Molina Complete Care (Virginia), Molina Healthcare of Arizona, Molina Healthcare of California, Molina Healthcare of Florida, Molina Healthcare of Idaho, Molina Healthcare of Iowa, Molina Healthcare of Michigan, Molina Healthcare of Nevada, Molina Healthcare of New Mexico, Molina Healthcare of Ohio, Molina Healthcare of South Carolina, Molina Healthcare of Texas, Molina Healthcare of Utah, Molina Healthcare of Washington, Molina Healthcare of Wisconsin, Molina Healthcare, Inc. (national grid), Rocky Mountain Health Plans, UnitedHealthcare, and others.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Cigna | ACA/IFP | All | prior auth required | May be delegated to eviCore for some clients | Oct 1, 2006 | Master Precertification List (For Health Care Providers) |
| Cigna | Basic Standard | All | prior auth required | May be delegated to eviCore for some clients | Oct 1, 2006 | Master Precertification List (For Health Care Providers) |
| Cigna | Complete/PHS+/Preferred | All | prior auth required | May be delegated to eviCore for some clients | Oct 1, 2006 | Master Precertification List (For Health Care Providers) |
| Cigna | Other Services | All | prior auth required | Experimental/investigational | Mar 7, 2026 | Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs |
| Cigna | Other Services | All | prior auth required | Experimental/investigational | Mar 7, 2026 | Cigna Commercial Prior Authorization Procedure Code List: Other Services |
| Humana | Oak Street Health | All | prior auth required | Oak Street Health (Humana): Prior Authorization List (PAL) Codes Under Management | ||
| 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 California | Medicare Advantage | CA | prior auth required | Jul 1, 2021 | Medicare Prior Auth (PA) Code Matrix (California), effective Q3 2021 | |
| Molina Healthcare of Florida | Medicare Advantage | FL | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Florida), effective Q2 2021 | |
| Molina Healthcare of Idaho | Medicare Advantage | ID | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Idaho), effective Q2 2021 | |
| Molina Healthcare of Iowa | Medicaid | IA | prior auth required | Jul 1, 2023 | IA Prior Authorization Matrix, effective Q3 2023 | |
| Molina Healthcare of Michigan | Exchange | MI | prior auth required | Jul 1, 2021 | Molina Healthcare of Michigan PA Matrix, effective 7/1/2021 | |
| Molina Healthcare of Nevada | Medicaid | NV | prior auth required | Oct 1, 2022 | Medicaid Prior Auth (PA) Code Matrix, effective Q4 2022 | |
| Molina Healthcare of New Mexico | Medicare Advantage | NM | prior auth required | Jan 1, 2021 | Medicare Prior Auth (PA) Code Matrix (New Mexico), effective Q1 2021 | |
| 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 South Carolina | Medicare Advantage | SC | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (South Carolina), effective Q2 2021 | |
| Molina Healthcare of Texas | Exchange | TX | prior auth required | Sep 1, 2019 | Marketplace Prior Authorization (PA) Code Matrix (Texas), effective July 1, 2026 | |
| Molina Healthcare of Utah | Medicare Advantage | UT | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Utah), effective Q2 2021 | |
| Molina Healthcare of Washington | Medicare Advantage | WA | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Washington), effective Q2 2021 | |
| Molina Healthcare of Wisconsin | Medicare Advantage | WI | prior auth required | Oct 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Wisconsin), effective Q4 2021 | |
| Molina Healthcare, Inc. (national grid) | Molina national (MHI) Medicare grid | All | prior auth required | Oct 1, 2021 | Medicare Prior Auth (PA) Code Matrix (national), effective Q4 2021 | |
| 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 | |
| UnitedHealthcare | UnitedHealthcare Complete (Individual & Family plans) | All | prior auth required | Sep 1, 2026 | Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026 | |
| UnitedHealthcare | UnitedHealthcare Individual Exchange plans | All | prior auth required | Oct 1, 2026 | Prior authorization requirements for UnitedHealthcare Individual Exchange plans Effective October 1, 2026 | |
| UnitedHealthcare Community Plan | North Carolina Medicaid | NC | prior auth required | Oct 1, 2026 | Prior authorization requirements for UnitedHealthcare Community Plan of North Carolina Effective October 1, 2026 July 1, 2024 | |
| UnitedHealthcare Community Plan | UnitedHealthcare Connected (Texas MMP) | TX | prior auth required | Jan 1, 2015 | Prior authorization requirements for UnitedHealthcare Connected (Medicare-Medicaid Plan) Texas Effective November 1, 2025 This list contains prior authorization review requirements for participating U |
69799 appears in 24 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Blue Shield of California, BlueCross BlueShield of South Carolina, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Myringotomy and Tympanostomy Tube (0418) | listed, no stance (range 69420-69799) | Jun 30, 2026 | payer document |
| Anthem | Implantable Middle Ear Hearing Aids (SURG.00084) | unproven / investigational | May 14, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Semiimplantable And Fully Implantable Middle Ear Hearing Aids | unproven / investigational | payer document | |
| Blue Cross NC | Semi-Implantable and Fully Implantable Middle Ear Hearing Aid | listed, no stance | Feb 1, 2026 | payer document |
| Blue Shield of California | Semi-Implantable and Fully Implantable Middle Ear Hearing Aids (7.01.84) | listed, no stance | payer document | |
| Blue Shield of California | | Balloon Dilation of the Eustachian Tube (7.01.158) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Semi-Implantable and Fully Implantable Middle Ear Hearing Aids (CAM 70184) | listed, no stance | May 1, 2026 | payer document |
| Cigna | Hearing Aids (0093) | covered if criteria are met | May 15, 2026 | payer document |
| Cigna | Hearing Aids (0093) | unproven / investigational | May 15, 2026 | payer 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 stance | Oct 1, 2026 | payer document |
| Regence | Balloon Dilation of the Eustachian Tube (Surgery 206) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone- Anchored, and Semi-Implantable (for Kansas Only) (CS052KS.04) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | 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) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | 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) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | 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) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (2026T0396II) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | listed, no stance | Mar 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (CS052.V) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | 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) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Hearing Aids and Devices Including Wearable, Bone-Anchored, and Semi-Implantable (for Indiana Only) (CS052IN.10) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | 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) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | 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) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | 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) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | 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) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | 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) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | 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) Semi-Implantable Electromagnetic Hearing Aids (SEHA) | listed, no stance | Aug 1, 2026 | payer document |
Prior authorization required or conditional in FL, KY, VT, WY.
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.