93272 CPT® code: payer coverage and prior authorization8 of 15 payer prior-auth lists that name 93272 require prior authorization or set conditions: Blue Shield of California, Molina Healthcare of California, Molina Healthcare of Illinois, Molina Healthcare of Michigan, Molina Healthcare of Ohio.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Shield of California | Blue Shield Medicare | CA | prior auth required | Sep 1, 2026 | Prior Authorization List for Blue Shield Medicare | |
| Blue Shield of California | Blue Shield commercial | CA | prior auth required | Sep 1, 2026 | Prior Authorization List for Blue Shield | |
| 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 | Medicare Advantage | MI | prior auth required | adults via Evolent | Jul 1, 2026 | Molina Healthcare of Michigan PA Matrix 2026-Q3 |
| 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 |
| Molina Healthcare of Ohio | Medicaid and MyCare Ohio (MMP) Medicaid | OH | prior auth under conditions | no PA under 18 | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 |
| Molina Healthcare of Ohio | Exchange | OH | prior auth under conditions | no PA under 18 | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 |
93272 appears in 10 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Blue Shield of California, Cigna, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Body Surface Potential Mapping (0705) | listed, no stance (range 93000-93278) | Nov 24, 2025 | payer document |
| Aetna | Cardiac Event Monitors (0073) | covered if criteria are met | Apr 7, 2026 | payer document |
| Aetna | Cardiac Event Monitors (0073) | listed, no stance | Apr 7, 2026 | payer document |
| Aetna | Nerve Blocks (0863) | listed, no stance (range 92920-93799) | Jul 23, 2026 | payer document |
| Aetna | Tilt Table Testing (0299) | listed, no stance (range 93224-93278) | May 15, 2026 | payer document |
| Anthem | External Ambulatory Cardiac Monitors (CG-MED-40) | covered if criteria are met (range 93268-93272) | Feb 19, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Ambulatory Event Monitors And Mobile Cardiac Outpatient Telemetry | covered if criteria are met | payer document | |
| Blue Cross NC | Ambulatory Event Monitors and Outpatient Cardiac Telemetry | listed, no stance | Jun 1, 2026 | payer document |
| Blue Shield of California | Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry (2.02.08) | listed, no stance | payer document | |
| Cigna | Ambulatory External and Implantable Electrocardiographic Monitoring (0547) | covered if criteria are met | Sep 15, 2026 | payer document |
| UnitedHealthcare | Ambulatory Electrocardiographic (AECG) Monitoring (MMP109.19) Event Monitor | listed, no stance | Sep 1, 2026 | payer document |
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.