99445 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 99445

Payer coverage policies that name 99445

99445 appears in 7 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Cigna, Molina Healthcare.

PayerPolicyRole in policyReviewedDocument
AetnaRemote Physiologic Monitoring (RPM) (1093)listed, no stanceMay 31, 2026payer document
AnthemRemote Therapeutic and Physiologic Monitoring Services (CG-MED-91)covered if criteria are metAug 13, 2026payer document
Blue Cross & Blue Shield of MississippiTelehealth Remote Patient Monitoring Services (L.2.04.439)listed, no stancepayer document
Blue Cross NCEvaluation and Management Serviceslisted, no stance (range 99202-99499)Jun 1, 2026payer document
Blue Cross NCRemote Therapeutic and Physiologic Monitoringlisted, no stanceFeb 1, 2026payer document
CignaRemote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM) (0563)listed, no stanceMay 15, 2026payer document
Molina HealthcareRemote Patient Monitoring Policy No. 419 (419)
N | e | x | t | R | e | v | i | e | w | D | u | e | B | y | : | O | c | t | o | b | e | r
listed, no stanceOct 8, 2025payer document

Medicaid fee-for-service

Prior authorization required or conditional in CO, IN, MS, VA, WA.

  • AZ: $27.64 (outpatient_hospital), effective Jan 1, 2026
  • CO: $39.54 (chp_plus, non-facility), effective Jul 1, 2026
  • KY: $37.46 (physician, facility), effective Jan 1, 2026
  • MS: $36.72 (comprehensive), effective Jul 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • NE: $47.91 (physician, non-facility), effective Jul 1, 2026
  • NY: $41.58 (midwife, non-facility), effective Jul 1, 2026
  • OH: $34.67 (code_changes), effective Jan 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $32.87 (physician, facility), effective Jul 1, 2026
  • WY: $16.50 (outpatient_hospital_apc, Ambulatory Surgical Centers), 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.