97014 CPT® code: payer coverage and prior authorization40 of 40 payer prior-auth lists that name 97014 require prior authorization or set conditions: Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of Texas, Blue Shield of California, CarePlus Health Plans, Humana, Molina Healthcare of Texas, UnitedHealthcare Community Plan.
97014 appears in 82 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross NC, Blue Shield of California, BlueCross BlueShield of South Carolina, Capital Blue Cross, Centene, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Attention Deficit/Hyperactivity Disorder (0426) EEG theta/beta power ratio, Gut microbiota profile, polygenic risk score, evaluation of kynurenine pathway | not covered | Jul 7, 2026 | payer document |
| Aetna | Autism Spectrum Disorders (0648) | listed, no stance (range 97010-97546) | Oct 2, 2025 | payer document |
| Aetna | Back Pain - Invasive Procedures (0016) | listed, no stance (range 97010-97039) | Oct 6, 2026 | payer document |
| Aetna | Back Pain - Invasive Procedures (0016) | listed, no stance (range 97010-97763) | Oct 6, 2026 | payer document |
| Aetna | Back Pain - Invasive Procedures (0016) | listed, no stance (range 97010-97799) | Oct 6, 2026 | payer document |
| Aetna | Back Pain - Invasive Procedures (0016) | listed, no stance (range 97010-97139) | Oct 6, 2026 | payer document |
| Aetna | Burn Garments (0062) | listed, no stance (range 97010-97028) | Jan 15, 2026 | payer document |
| Aetna | Chiropractic Services (0107) | listed, no stance (range 97010-97799) | Apr 7, 2026 | payer document |
| Aetna | Chronic Pain Rehabilitation Programs (0237) | listed, no stance (range 97010-97546) | Apr 23, 2026 | payer document |
| Aetna | Complementary and Alternative Medicine (0388) | listed, no stance | Jun 25, 2026 | payer document |
| Aetna | Complex Regional Pain Syndrome (CRPS): Treatments (0447) | listed, no stance (range 97010-97168) | Jul 16, 2026 | payer document |
| Aetna | Constraint-Induced Therapy (0665) | listed, no stance | Oct 8, 2026 | payer document |
| Aetna | Dysphagia Therapy (0625) | not covered | Sep 25, 2025 | payer document |
| Aetna | Eagle's and Ernest Syndrome (0400) | listed, no stance (range 97010-97028) | Jun 30, 2026 | payer document |
| Aetna | Electrical Stimulation for Chronic Ulcers (0680) | covered if criteria are met | Dec 29, 2025 | payer document |
| Aetna | Electrical Stimulation for Nausea, Vomiting, Motion Sickness and Other Selected Indications (0676) | listed, no stance | Oct 7, 2026 | payer document |
| Aetna | Electrodiagnostic Testing (0502) | listed, no stance (range 97010-97799) | Jul 29, 2026 | payer document |
| Aetna | Erectile Dysfunction and Peyronie's Disease (0007) | not covered | Jul 29, 2026 | payer document |
| Aetna | Facial Nerve Paralysis (0745) | not covered | Oct 30, 2025 | payer document |
| Aetna | Functional Electrical Stimulation and Neuromuscular Electrical Stimulation (0677) | listed, no stance (range 97010-97763) | Sep 10, 2026 | payer document |
| Aetna | Headaches: Invasive Procedures (0707) | not covered | Jul 23, 2026 | payer document |
| Aetna | Hip Arthroplasty (0287) | listed, no stance (range 97010-97546) | Sep 23, 2026 | payer document |
| Aetna | Home Health Aides (0218) | listed, no stance (range 97010-97799) | Sep 10, 2026 | payer document |
| Aetna | Idiopathic Scoliosis (0398) | covered if criteria are met | Sep 28, 2026 | payer document |
| Aetna | Intervertebral Disc Prostheses (0591) | listed, no stance (range 97010-97039) | Sep 18, 2026 | payer document |
| Aetna | Knee Arthroplasty (0660) | listed, no stance (range 97010-97799) | Oct 8, 2026 | payer document |
| Aetna | Levator Syndrome Treatments (0679) | covered if criteria are met | Oct 15, 2025 | payer document |
| Aetna | Pediatric Intensive Feeding Programs (0809) | not covered | Dec 11, 2025 | payer document |
| Aetna | Peripheral Electrical Nerve Stimulation for Pain (0011) | listed, no stance | Jun 3, 2026 | payer document |
| Aetna | Peripheral Electrical Nerve Stimulation for Pain (0011) | not covered | Jun 3, 2026 | payer document |
| Aetna | Physical Therapy (0325) | covered if criteria are met | Jun 2, 2026 | payer document |
| Aetna | Pulsed Electromagnetic Stimulation (0175) | listed, no stance | Jun 23, 2026 | payer document |
| Aetna | Spasticity Management (0362) | not covered | May 26, 2026 | payer document |
| Aetna | Speech Therapy (0243) | listed, no stance | May 13, 2026 | payer document |
| Aetna | Standing Frames, Tables, and Transfer Boards (0481) | listed, no stance (range 97001-97763) | Jul 2, 2026 | payer document |
| Aetna | Temporomandibular Disorders (0028) | not covered | Mar 12, 2026 | payer document |
| Aetna | Total Ankle Arthroplasty (0645) | listed, no stance (range 97001-97799) | Sep 14, 2026 | payer document |
| Aetna | Transforaminal Epidural Injections (0722) | listed, no stance (range 97010-97530) | Oct 20, 2025 | payer document |
| Aetna | Urinary Incontinence (0223) | covered if criteria are met | Jul 16, 2026 | payer document |
| Aetna | Urinary Incontinence (0223) | not covered | Jul 16, 2026 | payer document |
| Aetna | Vasectomy Procedures and Chronic Scrotal Content Pain (0027) | listed, no stance (range 97010-97799) | Jan 27, 2026 | payer document |
| Aetna | Vulvodynia and Vulvar Vestibulitis Treatments (0759) | covered if criteria are met (range 97010-97032) | Nov 12, 2025 | payer document |
| Blue Cross & Blue Shield of Mississippi | Electrical And Electromagnetic Stimulation For The Treatment Of Arthritis | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Mississippi | Electromyography Emg (L.2.01.417) | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Mississippi | Hwave Electrical Stimulation (L.1.01.410) | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Mississippi | Interferential Current Stimulation | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Mississippi | Neuromuscular Electrical Stimulation Nmes (L.8.03.401) | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Mississippi | Pelvic Floor Stimulation As A Treatment Of Urinary And Fecal Incontinence | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Mississippi | Temporomandibular Joint Disorder | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Mississippi | Tibial Nerve Stimulation (A.7.01.106) | listed, no stance | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Autism Spectrum Disorders Mandate | covered if criteria are met | Apr 15, 2026 | payer document |
| Blue Cross & Blue Shield of Rhode Island | Physical and Occupational Services PAYMENT POLICY | 3 | covered if criteria are met | Feb 17, 2026 | payer document |
| Blue Cross & Blue Shield of Rhode Island | Sympathetic Therapy for the Treatment of Pain sad | not covered | Jan 8, 2025 | payer document |
| Blue Cross NC | Chiropractic Services | listed, no stance | Sep 1, 2025 | payer document |
| Blue Cross NC | Rehabilitative Therapies | listed, no stance | Sep 1, 2025 | payer document |
| Blue Shield of California | Electrostimulation and Electromagnetic Therapy for Treating Wounds (2.01.57) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Interferential Current Stimulation (CAM 10124) | listed, no stance | Jan 1, 2026 | payer document |
| BlueCross BlueShield of South Carolina | Neuromuscular Electrical Stimulation (NMES) (CAM 014) | listed, no stance | Sep 1, 2026 | payer document |
| BlueCross BlueShield of South Carolina | Pelvic Floor Stimulation as a Treatment of Urinary and Fecal Incontinence (CAM 10117) | listed, no stance | Apr 1, 2026 | payer document |
| Capital Blue Cross | H-Wave Electrical Stimulation (MP 6.049) Procedure codes | unproven / investigational | Apr 1, 2026 | payer document |
| Capital Blue Cross | Investigational Physical Medicine and Specialized Physical Medicine Interventions (Outpatient) (MP 8.001) Procedure Codes | unproven / investigational | Sep 1, 2026 | payer document |
| Centene | Attention Deficit Hyperactivity Disorder Assessment and Treatment (CP.BH.124) | not covered | Mar 1, 2024 | payer document |
| Centene | Deep Transcranial Magnetic Stimulation for the Treatment of Obsessive Compulsive Disorder (CP.BH.201) | covered if criteria are met | Feb 1, 2025 | payer document |
| Centene | Transcranial Magnetic Stimulation for Treatment Resistant Major Depression (CP.BH.200) | covered if criteria are met | Apr 1, 2025 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Electrical and Electromagnetic Stimulation for the Treatment of Arthritis (MED201.042) | listed, no stance | Sep 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Electrostimulation and Electromagnetic Therapy for Treating Wounds (MED201.027) | listed, no stance | Apr 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Interferential Current Stimulation (MED201.041) | listed, no stance | Oct 15, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Pelvic Floor Stimulation as a Treatment of Urinary or Fecal Incontinence (DME101.037) | listed, no stance | Oct 15, 2025 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Sexual Dysfunctions, Assessment and Treatment (MED201.030) CPT Codes 37788, 37790, 54110, 54111, 54112, 54200, 54205, 54230, 54231, | listed, no stance | Jan 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Surface Electrical Stimulation (MED201.026) | listed, no stance | Jan 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Temporomandibular Joint Disorders (SUR705.010) CPT Codes 20550, 20605, 20606, 21010, 21050, 21060, 21070, 21073, 21076, | listed, no stance | Jan 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Transcutaneous Electrical Stimulation (TENS) and Transcutaneous Afferent Patterned Stimulation (MED201.040) | listed, no stance | Jun 15, 2026 | payer document |
| Premera Blue Cross | Preventive Care Covered with written prescription | The USPSTF recommends | covered if criteria are met | Sep 21, 2026 | payer document |
| Regence | Implantable Peripheral Nerve Stimulation and Peripheral Subcutaneous Field Stimulation (Surgery 205) | listed, no stance | Jul 1, 2026 | payer document |
| Regence | Pelvic Floor Stimulation or Mechanotransduction as a Treatment of Urinary and Fecal Incontinence (Allied Health 04) | listed, no stance | Nov 1, 2025 | payer document |
| UnitedHealthcare | Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (MP.026.27) | listed, no stance | Jul 1, 2026 | payer document |
| UnitedHealthcare | Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (CS164.M) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for Florida Only) (CS164FL.N) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for Idaho Only) (CS164ID.C) | listed, no stance | Sep 1, 2026 | payer document |
| UnitedHealthcare | Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for Kentucky Only) (CS164KY.10) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for Nebraska Only) (CS164NE.K) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for New Jersey Only) (CS164NJ.H) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for New Mexico Only) (CS164NM.C) | listed, no stance | Nov 1, 2025 | payer document |
| UnitedHealthcare | Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for North Carolina Only) (CSNC.MP.164.05) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for Ohio Only) (CS164OH.D) | listed, no stance | Nov 1, 2025 | payer document |
| UnitedHealthcare | Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) (for Pennsylvania Only) (CS164PA.E) | listed, no stance | Aug 1, 2026 | payer document |
| UnitedHealthcare | Habilitation and Rehabilitation Therapy (Occupational, Physical, and Speech) – Site of Service (for Florida Only) (CS161FL.M) | listed, no stance | Jun 1, 2026 | payer document |
Prior authorization required or conditional in CO, IN, MS, WV.
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.