96002 CPT® code: payer coverage and prior authorization2 of 2 payer prior-auth lists that name 96002 require prior authorization or set conditions: UnitedHealthcare Community Plan.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| UnitedHealthcare Community Plan | Indiana Hoosier Care Connect | IN | prior auth required | Oct 1, 2026 | Prior authorization requirements for Indiana Hoosier Care Connect Effective October 1, 2026 | |
| UnitedHealthcare Community Plan | Indiana PathWays for Aging (MLTSS) | IN | prior auth required | Oct 1, 2026 | Prior authorization requirements for Indiana MLTSS Pathways Effective October 1, 2026 |
96002 appears in 27 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Shield of California, BlueCross BlueShield of South Carolina, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Chiropractic Services (0107) | listed, no stance (range 96000-96004) | Apr 7, 2026 | payer document |
| Aetna | Gait Analysis and Electrodynogram (0263) | not covered | Apr 16, 2026 | payer document |
| Aetna | Obstructive Sleep Apnea in Children (0752) | not covered | Oct 30, 2025 | payer document |
| Aetna | Pedobarography (0294) | listed, no stance | Apr 17, 2026 | payer document |
| Aetna | Surface Scanning and Macro Electromyography (0112) Neurophysiologic Pain Profile (NPP), Spine Matrix Scan | not covered | Mar 25, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Electromyography Emg (L.2.01.417) | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Mississippi | Gait Analysis (L.2.01.420) | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Mississippi | Paraspinal Surface Electromyography To Evaluate And Monitor Back Pain | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Mississippi | Temporomandibular Joint Disorder | not covered | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Gait Analysis Medicare Advantage Plans and Commercial Products | listed, no stance | Feb 3, 2015 | payer document |
| Blue Shield of California | Paraspinal Surface Electromyography to Evaluate and Monitor Back Pain (2.01.35) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Paraspinal Surface Electromyography to Evaluate and Monitor Back Pain (CAM 20135) | listed, no stance | Oct 1, 2025 | payer document |
| Cigna | Gait Analysis (0315) | covered if criteria are met | Jun 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Surface Electromyography and Paraspinal Surface Electromyography to Evaluate and Monitor Back Pain (MED205.006) | listed, no stance | Oct 1, 2025 | payer document |
| Premera Blue Cross | Non-covered Experimental/Investigational Services Page | 29 of 38 | ∞ | listed, no stance | Oct 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (CS082.W) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (2026T0493II) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Idaho Only) (CS082ID.C) | listed, no stance | Jun 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Indiana Only) (CS082IN.10) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Kansas Only) (CS082KS.02) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Kentucky Only) (CS082KY.12) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Nebraska Only) (CS082NE.W) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for New Jersey Only) (CS082NJ.T) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for New Mexico Only) (CS082NM.C) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Ohio Only) (CS082OH.E) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Pennsylvania Only) (CS082PA.U) | listed, no stance | Apr 1, 2026 | payer document |
| UnitedHealthcare | Neurophysiologic Testing and Monitoring (for Tennessee Only) (CS082TN.U) | listed, no stance | Apr 1, 2026 | payer document |
Prior authorization required or conditional in IN.
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.