98981 CPT® code: payer coverage and prior authorization2 of 2 payer prior-auth lists that name 98981 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 |
98981 appears in 5 coverage policies from Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Cigna, Molina Healthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Anthem | Remote Therapeutic and Physiologic Monitoring Services (CG-MED-91) | covered if criteria are met | Aug 13, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Telehealth Remote Patient Monitoring Services (L.2.04.439) | listed, no stance | payer document | |
| Blue Cross NC | Remote Therapeutic and Physiologic Monitoring | listed, no stance | Feb 1, 2026 | payer document |
| Cigna | Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) (0563) | listed, no stance | May 15, 2026 | payer document |
| Molina Healthcare | Remote Patient Monitoring Policy No. 419 (419) | listed, no stance | Oct 8, 2025 | payer document |
Prior authorization required or conditional in CO, IN, MS, VA.
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.