96041 CPT® code: payer coverage and prior authorization1 of 1 payer prior-auth lists that name 96041 require prior authorization or set conditions: Blue Cross and Blue Shield of Illinois.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross and Blue Shield of Illinois | Blue Cross Community MMAI (Medicare-Medicaid Alignment Initiative) | IL | prior auth required | Jul 1, 2025 | Procedure Code List, Effective 1/1/2025 |
96041 appears in 11 coverage policies from Aetna, Blue Shield of California, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Back Pain - Noninvasive Treatments (0232) | listed, no stance | Apr 23, 2026 | payer document |
| Aetna | Genetic Counseling (0189) | covered if criteria are met | Mar 27, 2026 | payer document |
| Aetna | Genetic Testing (0140) | listed, no stance | Aug 18, 2026 | payer document |
| Blue Shield of California | Genetic Biomarker Testing (Including Liquid Biopsy) for Targeted Treatment in Advanced Cancer (2.04.151) | listed, no stance | payer document | |
| Blue Shield of California | Genetic Testing for Developmental Delay/Intellectual Disability, Autism Spectrum Disorder, and Congenital Anomalies (2.04.59) | listed, no stance | payer document | |
| Blue Shield of California | Genetic Testing for FMR1 Variants (Including Fragile X Syndrome) (2.04.83) | listed, no stance | payer document | |
| Blue Shield of California | Proteogenomic Testing for Patients With Cancer (2.04.140) | listed, no stance | payer document | |
| Blue Shield of California | Use of Common Genetic Variants (Single Nucleotide Variants) to Predict Risk of Nonfamilial Breast Cancer (2.04.63) | listed, no stance | payer document | |
| Blue Shield of California | | Preimplantation Genetic Testing (4.02.05) | listed, no stance | payer document | |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Biomarker Testing in Risk Assessment and Management of Cardiovascular Disease (MED207.008) CPT Codes 81291, 81401, 82172, 82397, 82465, 82610, 82652, 82664, 83090, | listed, no stance | Jul 15, 2026 | payer document |
| Premera Blue Cross | Preventive Care Breast cancer prevention counseling | covered if criteria are met | Sep 21, 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.