E1831 Static str toe dev ext/flexStatic progressive stretch toe device, extension and/or flexion, with or without range of motion adjustment, includes all components and accessories
32 of 32 payer prior-auth lists that name E1831 require prior authorization or set conditions: Rocky Mountain Health Plans, UnitedHealthcare Community Plan.
E1831 appears in 19 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts, Blue Shield of California, Centene, UnitedHealthcare.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Mechanical Stretching Devices for Contracture and Joint Stiffness (0405) Advance Dynamic ROM, Pro-glide dynamic ROM, SaeboReach, EZ Turnbuckle Orthosis | covered if criteria are met | Jun 30, 2026 | payer document |
| Aetna | Orthopedic Casts, Braces and Splints (0009) | listed, no stance (range E1800-E1840) | Jan 20, 2026 | payer document |
| Anthem | Static Progressive Stretch (SPS) and Patient-Actuated Serial Stretch (PASS) Devices (DME.00038) | unproven / investigational | May 14, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Patientcontrolled End Range Of Motion Stretching Devices | unproven / investigational | payer document | |
| Blue Cross & Blue Shield of Rhode Island | Patient-Controlled End of Range Motion Stretching Devices sad | not covered | Apr 1, 2026 | payer document |
| Blue Cross Blue Shield of Massachusetts | Patient-Controlled End of Range Motion Stretching Devices (721) | unproven / investigational | payer document | |
| Blue Shield of California | Patient-Controlled End Range of Motion Stretching Devices (1.03.05) | listed, no stance | payer document | |
| Centene | Mechanical Stretching Devices for Joint Stiffness and Contracture (CP.MP.144) | not covered | Oct 1, 2025 | payer document |
| UnitedHealthcare | Mechanical Stretching Devices (CS077.R) | listed, no stance | Dec 1, 2025 | payer document |
| UnitedHealthcare | Mechanical Stretching Devices (2026T0481BB) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Mechanical Stretching Devices (for Idaho Only) (CS077ID.D) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Mechanical Stretching Devices (for Indiana Only) (CS077IN.08) | listed, no stance | Feb 1, 2026 | payer document |
| UnitedHealthcare | Mechanical Stretching Devices (for Kansas Only) (CS077KS.03) | listed, no stance | Dec 1, 2025 | payer document |
| UnitedHealthcare | Mechanical Stretching Devices (for Kentucky Only) (CS077KY.09) | listed, no stance | May 1, 2026 | payer document |
| UnitedHealthcare | Mechanical Stretching Devices (for Nebraska Only) (CS077NE.R) | listed, no stance | Dec 1, 2025 | payer document |
| UnitedHealthcare | Mechanical Stretching Devices (for New Mexico Only) (CS077NM.E) | listed, no stance | Dec 1, 2025 | payer document |
| UnitedHealthcare | Mechanical Stretching Devices (for Ohio Only) (CS077OH.F) | listed, no stance | Jan 1, 2026 | payer document |
| UnitedHealthcare | Mechanical Stretching Devices (for Pennsylvania Only) (CS077PA.P) | listed, no stance | Dec 1, 2025 | payer document |
| UnitedHealthcare | Mechanical Stretching Devices (for Tennessee Only) (CS077TN.P) | listed, no stance | Dec 1, 2025 | payer document |
Prior authorization required or conditional in IN, MA, OH, 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.