99392 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 99392

1 of 1 payer prior-auth lists that name 99392 require prior authorization or set conditions: UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
UnitedHealthcare Community PlanKanCareKSprior auth under conditionssite of care: home, outpatientOct 1, 2026Prior authorization requirements for Kansas Medicaid Effective October 1, 2026

Payer coverage policies that name 99392

99392 appears in 5 coverage policies from Aetna, Blue Cross & Blue Shield of Rhode Island, Blue Cross NC, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaEarly Intervention Programs (0444)listed, no stanceJul 1, 2026payer document
AetnaIntensive Cardiac Rehabilitation Programs (0267)listed, no stance (range 99381-99397)May 14, 2026payer document
Blue Cross & Blue Shield of Rhode IslandTEMPORARY COVID-19 Pediatric Vaccination Preventative Medicine Counseling Services for Commercial Memberslisted, no stance (range 99391-99394)May 3, 2023payer document
Blue Cross NCEvaluation and Management Serviceslisted, no stance (range 99202-99499)Jun 1, 2026payer document
Blue Cross NCEvaluation and Management Serviceslisted, no stance (range 99381-99397)Jun 1, 2026payer document
Premera Blue CrossPreventive Care
Procedure Code(s) | Comments
covered if criteria are metSep 21, 2026payer document
Premera Blue CrossPreventive Care
Pregnancy Care
covered if criteria are met (range 99381-99397)Sep 21, 2026payer document

Medicaid fee-for-service

  • AZ: $27.50 (outpatient_hospital, RF133), effective Oct 1, 2024
  • CO: $90.12 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $53.31 (physician, facility), effective Jan 1, 2026
  • IL: $32.15 (practitioner), effective Jul 1, 2026
  • IN: $57.26 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $20.44 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $60.43 (physician, facility), effective Jan 1, 2026
  • LA: $83.33 (professional), effective Jul 1, 2025
  • MA: $59.30 (physician_medicine, facility), effective May 1, 2024
  • MS: $100.39 (comprehensive, PCP), effective Jul 1, 2026
  • ND: $120.53 (physician), effective Aug 1, 2026
  • NE: $94.91 (health_check), effective Jul 1, 2024
  • NY: $27.45 (nurse_practitioner, facility), effective Jul 1, 2026
  • OH: $40.93 (physician, facility), effective Jan 1, 2026
  • OK: $58.07 (physician, facility), effective Jul 1, 2026
  • TX: $84.04 (thsteps_medical, Thsteps Medical, facility), effective Sep 1, 2023
  • VA: $45.52 (medical, facility), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $57.67 (enhanced_pediatric, facility), effective Jul 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), effective Apr 1, 2026

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.