76014 CPT® code: payer coverage and prior authorization1 of 1 payer prior-auth lists that name 76014 require prior authorization or set conditions: Blue Shield of California Promise Health Plan.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Shield of California Promise Health Plan | Promise Health Plan Medi-Cal | CA | prior auth required | Sep 1, 2026 | Medi-Cal Prior Authorization List |
76014 appears in 1 coverage policy from Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Premera Blue Cross | Non-covered Services and Procedures Page | 7 of 30 | ∞ | listed, no stance | Jun 1, 2026 | payer document |
Prior authorization required or conditional in IN.
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.