Payer policies › CPT 9389793897 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 93897 1 of 1 payer prior-auth lists that name 93897 require prior authorization or set conditions: Blue Shield of California Promise Health Plan.
Payer Plan State Prior auth Conditions Since Source Blue Shield of California Promise Health Plan Promise Health Plan Medi-Cal CA prior auth required Sep 1, 2026 Medi-Cal Prior Authorization List
Payer coverage policies that name 93897 93897 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Transcranial Doppler Ultrasonography (0353) covered if criteria are met May 22, 2026 payer document
Recent prior-auth changes Feb 1, 2025: PA added, Blue Shield of California Promise Health Plan Medicaid fee-for-service Prior authorization required or conditional in MS.
AZ: $229.08 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $178.49 (chp_plus, non-facility), effective Jul 1, 2026 FL: $155.61 (physician), effective Jan 1, 2026 IL: $141.17 (practitioner), effective Jan 1, 2025 IN: $171.33 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KY: $177.01 (physician, facility), effective Jan 1, 2026 LA: $58.45 (professional), effective Jan 1, 2025 MS: $31.77 (comprehensive), effective Jul 1, 2026 ND: $40.93 (physician), effective Aug 1, 2026 OH: $160.23 (physician), effective Jan 1, 2025 OK: $200.65 (physician, non-facility), effective Jul 1, 2026 TX: $188.89 (miscellaneous_other_professionals_portable_x_ray_radiologica, Miscellaneous Other Professionals - Portable X-Ray, Radiological Lab, Physiological Lab, non-facility), effective Jan 1, 2025 VA: $32.41 (medical, facility), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $148.48 (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.