99394 CPT® code: payer coverage and prior authorization1 of 1 payer prior-auth lists that name 99394 require prior authorization or set conditions: UnitedHealthcare Community Plan.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| UnitedHealthcare Community Plan | KanCare | KS | prior auth under conditions | site of care: home, outpatient | Oct 1, 2026 | Prior authorization requirements for Kansas Medicaid Effective October 1, 2026 |
99394 appears in 4 coverage policies from Aetna, Blue Cross & Blue Shield of Rhode Island, Blue Cross NC, Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Intensive Cardiac Rehabilitation Programs (0267) | listed, no stance (range 99381-99397) | May 14, 2026 | payer document |
| Blue Cross & Blue Shield of Rhode Island | TEMPORARY COVID-19 Pediatric Vaccination Preventative Medicine Counseling Services for Commercial Members | listed, no stance (range 99391-99394) | May 3, 2023 | payer document |
| Blue Cross NC | Evaluation and Management Services | listed, no stance (range 99381-99397) | Jun 1, 2026 | payer document |
| Blue Cross NC | Evaluation and Management Services | listed, no stance (range 99202-99499) | Jun 1, 2026 | payer document |
| Premera Blue Cross | Preventive Care Procedure Code(s) | Comments | covered if criteria are met | Sep 21, 2026 | payer document |
| Premera Blue Cross | Preventive Care Pregnancy Care | covered if criteria are met (range 99381-99397) | 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.