70471 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 70471

35 of 41 payer prior-auth lists that name 70471 require prior authorization or set conditions: Aetna, Blue Cross Blue Shield of Arizona (AZ Blue), Blue Cross and Blue Shield of New Mexico, Blue Cross and Blue Shield of Texas, Cigna, HealthSpring, Humana, Molina Healthcare of Illinois, Molina Healthcare of Michigan, Molina Healthcare of New Mexico, Molina Healthcare of Texas, Passport by Molina Healthcare (Kentucky), Rocky Mountain Health Plans, UnitedHealthcare, UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross Blue Shield of Arizona (AZ Blue)AZ Blue-administered Medicare Advantage (M2K)AZprior auth requiredSep 1, 2026AZ Blue Medicare Advantage Prior Authorization Requirements Code List (Effective 09/01/2026)
Blue Cross Blue Shield of Arizona (AZ Blue)Federal Employee Program (FEP)AZprior auth requiredSep 1, 2026Federal Employee Program (FEP) Prior Authorization Requirements Code List (Updated 09/01/2026)
Blue Cross Blue Shield of Arizona (AZ Blue)Standard PA code list (most commercial plans)AZprior auth under conditionseviCore-delegated groups only; Gold-card eligibleSep 1, 2026AZ Blue Standard Prior Authorization Requirements Code List (09/01/2026)
Blue Cross Blue Shield of Arizona (AZ Blue)State of Arizona employee group (SYD, S3Z)AZprior auth requiredGold-card eligibleSep 1, 2026State of Arizona Group Prior Authorization Requirements Code List (09/01/2026)
AetnaCommercialAllprior auth requiredNot required for Student Health or Allina Health | Aetna plans; Not required inpatient, in the ER or in observationOct 1, 2026Participating provider precertification list for Aetna®
AetnaMedicare AdvantageAllprior auth requiredNot required for Student Health or Allina Health | Aetna plans; Not required inpatient, in the ER or in observationOct 1, 2026Participating provider precertification list for Aetna®
CignaACA/IFPAllprior auth requiredMay be delegated to eviCore for some clientsJan 1, 2026Master Precertification List (For Health Care Providers)
CignaComplete/PHS+/PreferredAllprior auth requiredMay be delegated to eviCore for some clientsJan 1, 2026Master Precertification List (For Health Care Providers)
CignaRadiologyAllprior auth requiredMar 7, 2026Cigna Commercial Prior Authorization Procedure Code List: Radiology
CignaRadiologyAllprior auth requiredMar 7, 2026Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs
Blue Cross and Blue Shield of New MexicoTurquoise Care (New Mexico Medicaid)NMprior auth requiredCarelon-managedJul 1, 2026New Mexico Medicaid Benefit Preauthorization Procedure Code List 10/1/26
Blue Cross and Blue Shield of TexasTexas PA exemption (gold card), outpatient, fully insuredTXprior auth requiredGold-card exemption availableJul 1, 2026BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range)
HealthSpringMedicare AdvantageAllprior auth requiredJan 1, 20252026 Q4 Prior Authorization List
HumanaDiagnostic ImagingAllprior auth under conditionssite of care: office or outpatientHumana Prior Authorization List (PAL): Diagnostic Imaging Services
HumanaDiagnostic ImagingAllprior auth under conditionssite of care: office or outpatientHumana Prior Authorization List (PAL): Diagnostic Imaging Services
HumanaHumana Healthy HorizonsOKprior auth requiredJan 1, 2027Humana Healthy Horizons® in Oklahoma Prior Authorization Notification List (PAL) The following preauthorization and notification list
Molina Healthcare of IllinoisMedicaidILprior auth requiredJul 1, 2026Molina Healthcare of Illinois Codification Grid Q3 2026
Molina Healthcare of MichiganMedicare AdvantageMIprior auth requiredJul 1, 2026Molina Healthcare of Michigan PA Matrix 2026-Q3
Molina Healthcare of MichiganMedicaidMIprior auth requiredJul 1, 2026Molina Healthcare of Michigan PA Matrix 2026-Q3
Molina Healthcare of New MexicoMedicaidNMprior auth requiredJul 1, 2026New Mexico Medicaid Prior Auth (PA) Code Matrix, effective July 1, 2026
Molina Healthcare of TexasSTAR, STAR+PLUS, STAR Kids, CHIP (Medicaid PA code matrix)TXprior auth requiredJul 1, 2026Medicaid Behavioral Health and Medical Prior Authorization (PA) Code Matrix (Texas), 2026-Q3
Molina Healthcare of TexasExchangeTXprior auth requiredJul 1, 2026Marketplace Prior Authorization (PA) Code Matrix (Texas), effective July 1, 2026
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 Health Plans Prime / RAECOprior auth requiredOct 1, 2026Rocky Mountain Health Plans PRIME Effective October 1, 2026
UnitedHealthcareUnitedHealthcare Complete (Individual & Family plans)Allprior auth requiredSep 1, 2026Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026
UnitedHealthcareUnitedHealthcare Individual Exchange plansAllprior auth requiredsite of care: site of service reviewedOct 1, 2026Prior authorization requirements for UnitedHealthcare Individual Exchange plans Effective October 1, 2026
UnitedHealthcare Community PlanNorth Carolina MedicaidNCprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of North Carolina Effective October 1, 2026 July 1, 2024
UnitedHealthcare Community PlanTennCareTNprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Tennessee Effective October 1, 2026
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 requiredSep 1, 2026Prior 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 requiredSep 1, 2026Prior 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 requiredSep 1, 2026Prior 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 Community Plan of FloridaFLprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHeathcare Community Plan of Florida Effective October 1, 2026
UnitedHealthcare Community PlanUnitedHealthcare Community Plan of New YorkNYprior auth requiredOct 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of New York Effective October 1, 2026

Payer coverage policies that name 70471

70471 appears in 6 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaCardiac Computed Tomography (CT), Coronary CT Angiography, Calcium Scoring and CT Fractional Flow Reserve (0228)covered if criteria are metJul 21, 2026payer document
AetnaCerebrovascular Angioplasty, Stenting, and Select Surgical Procedures (0276)listed, no stanceSep 10, 2026payer document
Blue Cross & Blue Shield of MississippiComputed Tomography Cat Scan And Computed Tomographic Angiography Cta Of The Head And Neck (L.6.01.403)covered if criteria are metpayer document
Blue Cross Blue Shield of MassachusettsVascular Imaging CPT, HCPCS and Diagnoses Codes (936)listed, no stancepayer document
UnitedHealthcareMagnetic Resonance Imaging (MRI) and Computed Tomography (CT) Scan – Site of Service (MP.13.20)
Computed Tomography
listed, no stanceSep 1, 2026payer document
UnitedHealthcareOutpatient Radiology Procedures for EviCore Arrangement (for Oxford Only) (RADIOLOGY)
Dates of Service
listed, no stanceSep 1, 2026payer document

Recent prior-auth changes

  • Oct 1, 2026: PA added, UnitedHealthcare Community Plan
  • Oct 1, 2026: PA added, UnitedHealthcare Community Plan
  • Sep 1, 2026: PA added, UnitedHealthcare
  • Sep 1, 2026: PA added, UnitedHealthcare
  • Sep 1, 2026: PA added, UnitedHealthcare Community Plan
  • Sep 1, 2026: PA added, UnitedHealthcare Community Plan
  • Sep 1, 2026: PA added, UnitedHealthcare Community Plan
  • Sep 1, 2026: PA added, Rocky Mountain Health Plans
  • Sep 1, 2026: PA added, UnitedHealthcare Community Plan
  • Sep 1, 2026: PA added, Rocky Mountain Health Plans

Medicaid fee-for-service

Prior authorization required or conditional in CO, IN, MS.

  • AZ: $134.76 (asc), effective Oct 1, 2026
  • CO: $269.39 (health_first_colorado), effective Jul 1, 2026
  • FL: $91.96 (radiology), effective Jan 1, 2026
  • IL: $248.61 (practitioner), effective Jan 1, 2026
  • KY: $306.16 (physician, facility), effective Jan 1, 2026
  • LA: $291.96 (lab_radiology), effective Jan 1, 2026
  • MS: $154.04 (comprehensive, facility), effective Jan 1, 2026
  • ND: $110.80 (physician, facility), effective Aug 1, 2026
  • NY: $327.55 (physician_radiology, facility), effective Apr 1, 2026
  • OH: $281.70 (code_changes), effective Jan 1, 2026
  • OK: $216.05 (physician, non-facility), effective Jul 1, 2026
  • TX: $449.10 (hospital_outpatient_imaging_services, Rural Hospitals), effective Jan 1, 2026
  • VA: $227.27 (medical, facility), effective Jan 1, 2026
  • VT: $270.89 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $163.20 (physician, facility), effective Jul 1, 2026
  • WY: $154.28 (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.