93050 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 93050

Payer coverage policies that name 93050

93050 appears in 18 coverage policies from Aetna, Capital Blue Cross, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaBody Surface Potential Mapping (0705)listed, no stance (range 93000-93278)Nov 24, 2025payer document
AetnaCardiovascular Disease Risk Tests (0381)not coveredAug 25, 2026payer document
AetnaCardiovascular Monitoring Equipment for Home Use: Pulse, Blood Pressure, Telemonitors, and Pacemaker Monitors (0548)not coveredAug 21, 2026payer document
AetnaNerve Blocks (0863)listed, no stance (range 92920-93799)Jul 23, 2026payer document
Capital Blue CrossCardiac Hemodynamic Monitoring for the Management of Heart Failure in the Outpatient Setting (MP 2.051)
Procedure Codes		unproven / investigationalSep 1, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Non-Invasive Measurement of Central Blood Pressure (cBP) (MED202.070)listed, no stanceSep 15, 2026payer document
UnitedHealthcareCardiovascular Diagnostic and Therapeutic Procedures (MMP013.22)
Arterial Compliance Testing, Using Waveform Analysis		listed, no stanceSep 1, 2026payer document
UnitedHealthcareCardiovascular Disease Risk Tests (2026T0389EE)listed, no stanceApr 1, 2026payer document
UnitedHealthcareCardiovascular Disease Risk Tests (CS015.W)listed, no stanceMay 1, 2026payer document
UnitedHealthcareCardiovascular Disease Risk Tests (for Idaho Only) (CS015ID.B)listed, no stanceJul 1, 2026payer document
UnitedHealthcareCardiovascular Disease Risk Tests (for Kansas Only) (CS015KS.03)listed, no stanceMay 1, 2026payer document
UnitedHealthcareCardiovascular Disease Risk Tests (for Kentucky Only) (CS015KY.10)listed, no stanceJan 1, 2026payer document
UnitedHealthcareCardiovascular Disease Risk Tests (for Nebraska Only) (CS015NE.W)listed, no stanceMay 1, 2026payer document
UnitedHealthcareCardiovascular Disease Risk Tests (for New Jersey Only) (CS015NJ.R)listed, no stanceMay 1, 2026payer document
UnitedHealthcareCardiovascular Disease Risk Tests (for New Mexico Only) (CS015NM.D)listed, no stanceMay 1, 2026payer document
UnitedHealthcareCardiovascular Disease Risk Tests (for Ohio Only) (CS015OH.G)listed, no stanceJun 1, 2026payer document
UnitedHealthcareCardiovascular Disease Risk Tests (for Pennsylvania Only) (CS015PA.S)listed, no stanceMay 1, 2026payer document
UnitedHealthcareCardiovascular Disease Risk Tests (for Tennessee Only) (CS015TN.S)listed, no stanceMay 1, 2026payer document

Medicaid fee-for-service

  • AZ: $17.89 (outpatient_hospital), effective Oct 1, 2021
  • FL: $6.75 (physician), effective Jan 1, 2026
  • IL: $10.59 (practitioner), effective Apr 1, 2024
  • IN: $6.21 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KY: $13.54 (physician, facility), effective Jan 1, 2026
  • LA: $14.83 (professional), effective Jan 1, 2016
  • MA: $12.06 (physician_medicine), effective May 1, 2024
  • MS: $7.15 (comprehensive), effective Jul 1, 2026
  • ND: $9.39 (physician), effective Aug 1, 2026
  • NE: $19.73 (physician, non-facility), effective Jul 1, 2026
  • NY: $11.36 (physician_medicine, facility), effective Jul 1, 2026
  • OH: $13.60 (physician), effective Jan 1, 2016
  • VA: $7.23 (medical, facility), effective Jul 1, 2026
  • VT: $22.46 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $12.79 (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.