93583 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 93583

9 of 11 payer prior-auth lists that name 93583 require prior authorization or set conditions: Molina Complete Care (Virginia), Molina Healthcare of Iowa, Molina Healthcare of Mississippi, Molina Healthcare of Nevada, Molina Healthcare of Ohio, Molina Healthcare of Utah, Neighborhood Health Partnership, UnitedHealthcare.

PayerPlanStatePrior authConditionsSinceSource
Molina Complete Care (Virginia)MedicaidVAprior auth requiredApr 1, 2025Virginia Medicaid PA Code Matrix and Virginia code/benefit exceptions, effective Q2 2025
Molina Healthcare of IowaMedicaidIAprior auth requiredJul 1, 2023IA Prior Authorization Matrix, effective Q3 2023
Molina Healthcare of MississippiMedicaidMSprior auth requiredadults via EvolentJan 1, 2025Mississippi Medicaid Prior Auth (PA) Code Matrix and exceptions, effective Q1 2025
Molina Healthcare of NevadaMedicaidNVprior auth requiredadults via NCHOct 1, 2022Medicaid Prior Auth (PA) Code Matrix, effective Q4 2022
Molina Healthcare of OhioMedicaid and MyCare Ohio (MMP) MedicaidOHprior auth under conditionsno PA under 18Oct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of OhioExchangeOHprior auth under conditionsno PA under 18Oct 1, 2023Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01
Molina Healthcare of UtahMedicaidUTprior auth requiredJan 1, 2025Utah Medicaid Prior Auth (PA) Code Matrix and Utah code/benefit exceptions, Q1 2025
Neighborhood Health PartnershipNeighborhood Health PartnershipFLprior auth under conditionsonly with dx I27.83, Q20.0, Q20.1, Q20.2, Q20.3, Q20.4Sep 1, 2026Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026
UnitedHealthcareUnitedHealthcare Complete (Individual & Family plans)Allprior auth requiredSep 1, 2026Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026

Payer coverage policies that name 93583

93583 appears in 3 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaCardiac Catheter Ablation (0165)not coveredAug 25, 2026payer document
AetnaNerve Blocks (0863)listed, no stance (range 92920-93799)Jul 23, 2026payer document
AetnaPercutaneous Transluminal Septal Myocardial Ablation (PTSMA) (0558)covered if criteria are metAug 21, 2026payer document

Recent prior-auth changes

  • Oct 1, 2026: PA removed, Oxford Health Plans
  • Oct 1, 2026: PA removed, Surest
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Oct 1, 2026: PA removed, UnitedHealthcare
  • Jan 1, 2026: PA removed, Molina Healthcare of Michigan
  • Jan 1, 2026: PA removed, Molina Healthcare of Illinois
  • Jan 1, 2026: PA removed, Passport by Molina Healthcare (Kentucky)
  • Oct 1, 2025: conditions changed, UnitedHealthcare

Medicaid fee-for-service

  • AZ: $736.74 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $580.37 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $498.88 (physician, non-facility), effective Jan 1, 2026
  • IL: $514.90 (practitioner), effective Apr 1, 2024
  • IN: $542.47 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $315.71 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $605.33 (physician, facility), effective Jan 1, 2026
  • LA: $648.62 (professional), effective Jan 1, 2014
  • MA: $526.06 (physician_medicine), effective May 1, 2024
  • MS: $540.98 (comprehensive), effective Jul 1, 2026
  • ND: $649.23 (physician), effective Aug 1, 2026
  • NE: $39.48 (physician, non-facility), effective Jul 1, 2026
  • NY: $433.27 (physician_medicine, facility), effective Jul 1, 2026
  • OH: $571.85 (physician), effective Jan 1, 2024
  • OK: $569.19 (physician, non-facility), effective Jul 1, 2026
  • TX: $580.32 (physician, Physician, facility), effective Sep 1, 2025
  • VA: $555.27 (medical), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $364.43 (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.