90882 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 90882

Payer coverage policies that name 90882

90882 appears in 3 coverage policies from Aetna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaEye Movement Desensitization and Reprocessing (EMDR) Therapy (0583)listed, no stance (range 90832-90899)Sep 18, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Medical Policies Moving to MCG Guidelines
Spectrum Disorders (ASD) | 70460, 70470, 70496, 70551, | Disorders – Gene Panels
listed, no stanceJan 1, 2026payer document
Premera Blue CrossNon-covered Services and Procedures
Page | 9 of 30 | ∞
listed, no stanceJun 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • KS: $10.00 (default), effective Aug 1, 2014
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 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.