HCPCS Level II › C codes C8002 Prep skin cell susp, automtdPreparation of skin cell suspension autograft, automated, including all enzymatic processing and device components (do not report with manual suspension preparation)
Medicare coverage: Carrier judgment Status: active (October 2026 file) Medically Unlikely Edits (effective October 1, 2026) Practitioner: max 1 units per day (clinical), rationale: Nature of Service/Procedure Outpatient hospital: max 1 units per day (clinical), rationale: Nature of Service/Procedure Payer policies and prior authorization for C8002 16 of 16 payer prior-auth lists that name C8002 require prior authorization or set conditions: CarePlus Health Plans, Cigna, Humana.
Payer Plan State Prior auth Conditions Since Source Cigna ACA/IFP All prior auth required May be delegated to eviCore for some clients Jan 1, 2025 Master Precertification List (For Health Care Providers) Cigna Basic Standard All prior auth required May be delegated to eviCore for some clients Jan 1, 2025 Master Precertification List (For Health Care Providers) Cigna Complete/PHS+/Preferred All prior auth required May be delegated to eviCore for some clients Jan 1, 2025 Master Precertification List (For Health Care Providers) Cigna Other Services All prior auth required Experimental/investigational Mar 7, 2026 Cigna Commercial Prior Authorization Procedure Code List: Other Services Cigna Other Services All prior auth required Experimental/investigational Mar 7, 2026 Cigna Commercial Comprehensive CPT Code Reference for Prior Authorization Across All Programs CarePlus Health Plans CarePlus Health Plans FL prior auth required Jan 1, 2027 Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List Humana Humana D-SNP (FL) FL prior auth required Jan 1, 2027 1 *New prior authorization requirement 787403FL0725 FLHMQSREN Humana Dual Fully Integrated Florida Prior Authorization and Notification List Humana Humana D-SNP (IL) IL prior auth required Jan 1, 2027 Humana Dual Fully Integrated Illinois Prior Authorization and Notification List Humana Humana D-SNP (IN) IN prior auth required Jan 1, 2027 *New prior authorization requirement 814403IN0825 H4939_INHN6Z6EN_C Humana PathWays Dual Care (HMO-POS D-SNP) Indiana Prior Authorization and Notification List Humana Humana D-SNP (MI) MI prior auth required Jan 1, 2027 1 Humana Dual Highly Integrated Michigan Prior Authorization and Notification List Humana Humana D-SNP (SC) SC prior auth required Jan 1, 2027 Humana Dual Highly Integrated South Carolina Prior Authorization and Notification List Humana Humana D-SNP (VA) VA prior auth required Jan 1, 2027 Virginia Prior Authorization and Notification List Humana Humana Healthy Horizons IN prior auth required New PA requirement Jan 1, 2027 1 Humana Healthy Horizons® in Indiana Preauthorization and Notification List (PAL) for Indiana PathWays for Aging Please note the term prior authorization when used in this communication, is defined a Humana Humana Healthy Horizons KY prior auth required Jan 1, 2027 please visit Humana Healthy Horizons in Kentucky Clinical coverage policies. Humana Humana MA and D-SNP All prior auth required Jan 1, 2027 Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List Humana Humana Puerto Rico MA and Dual Medicare-Medicaid PR prior auth required Nov 3, 2025 Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification
Payer coverage policies that name C8002 C8002 appears in 9 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Capital Blue Cross, Centene, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Regence.
Payer Policy Role in policy Reviewed Document Aetna Skin and Soft Tissue Substitutes (0244) not covered Jul 29, 2026 payer document Anthem Products for Wound Healing and Soft Tissue Grafting: Medically Necessary Uses (CG-SURG-127) covered if criteria are met Aug 13, 2026 payer document Blue Cross & Blue Shield of Mississippi Bioengineered Skin And Soft Tissue Substitutes (A.7.01.113) unproven / investigational payer document Blue Cross Blue Shield of Massachusetts Bioengineered Skin and Soft Tissue Substitutes (663)Procedure unproven / investigational payer document Capital Blue Cross Experimental and Investigational Procedures (MP 4.002)Procedure codes: Integumentary listed, no stance Sep 1, 2026 payer document Centene Skin and Soft Tissue Substitutes (CP.MP.185) not covered Apr 1, 2026 payer document Cigna Tissue-Engineered Skin Substitutes (0068) unproven / investigational Jun 15, 2026 payer document Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) Bioengineered Skin and Soft Tissue Substitutes (SUR704.012)HCPCS Codes A2002, A2004, A2005, A2006, A2007, A2008, A2009, A2010, A2011, listed, no stance Jul 1, 2026 payer document Regence Bioengineered Skin and Soft Tissue Substitutes and Amniotic Products (Medicine 170) listed, no stance Jun 1, 2026 payer document
Recent prior-auth changes Jan 1, 2027: PA added, Humana Jan 1, 2027: PA added, Humana Jul 1, 2026: PA added, Humana Medicaid fee-for-service AZ: $2131.34 (asc), effective Oct 1, 2026 KY: $3802.44 (asc), effective Jan 1, 2026 MA: $2852.13 (asc), effective May 1, 2026 MS: $3113.82 (comprehensive, facility), effective Oct 1, 2025 ND: $2241.54 (physician, facility), effective Aug 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WY: $3138.46 (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.