95065 CPT® code: payer coverage and prior authorization1 of 1 payer prior-auth lists that name 95065 require prior authorization or set conditions: Rocky Mountain Health Plans.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Rocky Mountain Health Plans | Rocky Mountain Medicare Advantage D-SNP | CO | prior auth required | Feb 1, 2025 | Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025 |
95065 appears in 9 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Centene, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Regence.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Allergy and Hypersensitivity (0038) | not covered | Mar 10, 2026 | payer document |
| Aetna | Autism Spectrum Disorders (0648) | not covered | Oct 2, 2025 | payer document |
| Aetna | Omalizumab (0670) | listed, no stance (range 95004-95079) | Aug 21, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Allergy Testing (L.2.01.428) | not covered | payer document | |
| Blue Cross & Blue Shield of Mississippi | Allergy Tests Of Uncertain Efficacy (L.2.01.429) | unproven / investigational | payer document | |
| Blue Cross NC | Allergy Skin and Challenge Testing | listed, no stance | Nov 1, 2025 | payer document |
| Centene | Allergy Testing and Therapy (CP.MP.100) | not covered | Sep 1, 2023 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Medical Policies Moving to MCG Guidelines Spectrum Disorders (ASD) | 70460, 70470, 70496, 70551, | Disorders – Gene Panels | listed, no stance | Jan 1, 2026 | payer document |
| Regence | Allergy and Sensitivity Tests of Uncertain Efficacy (Laboratory 01) | listed, no stance | Jun 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.