77011 CPT® code: payer coverage and prior authorization4 of 9 payer prior-auth lists that name 77011 require prior authorization or set conditions: Blue Cross Blue Shield of Arizona (AZ Blue), Molina Healthcare of California, Molina Healthcare of Illinois, Molina Healthcare of Michigan.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross Blue Shield of Arizona (AZ Blue) | Federal Employee Program (FEP) | AZ | prior auth under conditions | FEP Blue Focus only | Sep 1, 2026 | Federal Employee Program (FEP) Prior Authorization Requirements Code List (Updated 09/01/2026) |
| Molina Healthcare of California | Medicaid | CA | prior auth required | Apr 1, 2026 | Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026 | |
| Molina Healthcare of Illinois | Medicaid | IL | prior auth required | Jan 1, 2022 | Molina Healthcare of Illinois Codification Grid Q3 2026 | |
| Molina Healthcare of Michigan | Medicaid | MI | prior auth under conditions | adults via Evolent; no PA for pediatrics | Jul 1, 2026 | Molina Healthcare of Michigan PA Matrix 2026-Q3 |
77011 appears in 2 coverage policies from Aetna.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Breast Biopsy Procedures (0269) | listed, no stance | May 14, 2026 | payer document |
| Aetna | Sinus Surgeries (0937) | listed, no stance | Apr 10, 2026 | payer document |
Prior authorization required or conditional in FL.
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.