93585 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 93585

4 of 9 payer prior-auth lists that name 93585 require prior authorization or set conditions: Molina Healthcare of California, Molina Healthcare of Illinois, Molina Healthcare of Michigan.

PayerPlanStatePrior authConditionsSinceSource
Molina Healthcare of CaliforniaMedicaidCAprior auth requiredApr 1, 2026Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026
Molina Healthcare of IllinoisMedicaidILprior auth requiredApr 1, 2024Molina Healthcare of Illinois Codification Grid Q3 2026
Molina Healthcare of MichiganMedicaidMIprior auth under conditionsadults via Evolent; no PA for pediatricsJul 1, 2026Molina Healthcare of Michigan PA Matrix 2026-Q3
Molina Healthcare of MichiganMedicare AdvantageMIprior auth requiredadults via EvolentJul 1, 2026Molina Healthcare of Michigan PA Matrix 2026-Q3

Payer coverage policies that name 93585

93585 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaNerve Blocks (0863)listed, no stance (range 92920-93799)Jul 23, 2026payer document

Recent prior-auth changes

  • Jan 1, 2026: conditions changed, Molina Healthcare of Michigan
  • Jan 1, 2026: PA added, Molina Healthcare of Michigan
  • Apr 1, 2024: PA added, Molina Healthcare of Michigan
  • Apr 1, 2024: PA added, Molina Healthcare of Illinois

Medicaid fee-for-service

Prior authorization required or conditional in VA.

  • AZ: $56.14 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $43.02 (health_first_colorado), effective Jul 1, 2026
  • FL: $37.46 (physician, non-facility), effective Jan 1, 2026
  • IL: $38.50 (practitioner), effective Jan 1, 2024
  • IN: $42.54 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KY: $46.64 (physician, facility), effective Jan 1, 2026
  • LA: $46.58 (professional), effective Jan 1, 2024
  • MA: $40.26 (physician_medicine), effective May 1, 2024
  • MS: $40.06 (comprehensive), effective Jul 1, 2026
  • ND: $50.32 (physician), effective Aug 1, 2026
  • NY: $45.87 (physician_medicine, facility), effective Jul 1, 2026
  • OH: $41.85 (physician), effective Jan 1, 2024
  • OK: $41.97 (physician, non-facility), effective Jul 1, 2026
  • VA: $39.93 (medical, facility), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $26.95 (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.