Payer policies › CPT 7693776937 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 76937 2 of 9 payer prior-auth lists that name 76937 require prior authorization or set conditions: Molina Healthcare of Ohio.
Payer coverage policies that name 76937 76937 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Ultrasound Guidance – Selected Indications (0952) covered if criteria are met Apr 27, 2026 payer document
Recent prior-auth changes Jan 1, 2026: PA removed, Molina Healthcare of Illinois Jan 1, 2026: PA removed, Molina Healthcare of Michigan Jul 1, 2024: conditions changed, Molina Healthcare of Illinois Jan 1, 2024: PA added, Molina Healthcare of Michigan Medicaid fee-for-service AZ: $39.40 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $10.87 (chp_plus, non-facility), effective Jul 1, 2026 FL: $7.67 (radiology), effective Jan 1, 2026 IL: $25.07 (practitioner), effective Apr 1, 2024 IN: $10.54 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $23.37 (default, Exempt Physician), effective Jan 1, 2024 KY: $0.00 (asc), effective Jan 1, 2026 LA: $11.92 (lab_radiology), effective Jul 1, 2025 MA: $20.36 (physician_radiology), effective May 1, 2024 MS: $20.67 (comprehensive), effective Jul 1, 2026 ND: $44.68 (physician), effective Aug 1, 2026 NE: $22.15 (physician, non-facility), effective Jul 1, 2026 NY: $55.55 (ordered_ambulatory), effective Jul 24, 2026 OH: $24.96 (physician), effective Jan 1, 2024 OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026 TX: $19.78 (miscellaneous_other_professionals_portable_x_ray_radiologica, Miscellaneous Other Professionals - Portable X-Ray, Radiological Lab, Physiological Lab, non-facility), effective Mar 1, 2025 VA: $23.15 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $16.82 (physician, facility), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.