70350 CPT® code: payer coverage and prior authorization1 of 1 payer prior-auth lists that name 70350 require prior authorization or set conditions: Rocky Mountain Health Plans.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| 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 |
70350 appears in 7 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Shield of California, BlueCross BlueShield of South Carolina, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Obstructive Sleep Apnea in Adults (0004) | covered if criteria are met | Oct 6, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Temporomandibular Joint Disorder | covered if criteria are met | payer document | |
| Blue Shield of California | | Temporomandibular Joint Disorder (2.01.21) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Temporomandibular Joint Dysfunction (CAM 20121) | listed, no stance | Aug 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Temporomandibular Joint Disorders (SUR705.010) CPT Codes 20550, 20605, 20606, 21010, 21050, 21060, 21070, 21073, 21076, | listed, no stance | Jan 1, 2026 | payer document |
| Premera Blue Cross | Computerized Diagnostic Imaging for Complex Maxillofacial Procedures | listed, no stance | Jun 22, 2026 | payer document |
| Premera Blue Cross | Temporomandibular Joint Disorder (2.01.535) Page | 4 of 20 | ∞ | listed, no stance | Apr 13, 2026 | payer document |
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.