S5161 Emer rspns sys serv permonthEmergency response system; service fee, per month (excludes installation and testing)
Status I: not valid for Medicare (Medicare uses another code).
15 of 15 payer prior-auth lists that name S5161 require prior authorization or set conditions: Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of New Mexico, Humana, Molina Complete Care (Virginia), Molina Healthcare of California, Molina Healthcare of Idaho, Molina Healthcare of Iowa, Molina Healthcare of Texas, UnitedHealthcare Community Plan.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Blue Cross and Blue Shield of Illinois | Blue Cross Community Health Plans (BCCHP), Illinois Medicaid | IL | prior auth required | Oct 1, 2026 | Illinois Medicaid Prior Authorization Code List, Effective 10/1/2026 | |
| Blue Cross and Blue Shield of Illinois | Blue Cross Community MMAI (Medicare-Medicaid Alignment Initiative) | IL | prior auth required | Jan 1, 2025 | Procedure Code List, Effective 1/1/2025 | |
| Blue Cross and Blue Shield of New Mexico | Turquoise Care (New Mexico Medicaid) | NM | prior auth required | Oct 1, 2026 | New Mexico Medicaid Benefit Preauthorization Procedure Code List 10/1/26 | |
| Humana | Humana LTSS (Dual/integrated plan) | IL | prior auth required | Jan 1, 2027 | Humana Dual Fully Integrated (HMO D-SNP) Illinois long-term services and supports prior authorization and notification list | |
| Humana | Humana LTSS (Dual/integrated plan) | IN | prior auth required | Jul 1, 2024 | Humana Gold Plus Integrated Indiana Long‐Term Services and Supports (LTSS) Preauthorization and Notification List Humana Gold Plus Integrated Indiana Long‐Term Services and Supports (LTSS) Preauthoriz | |
| Humana | Humana LTSS (Healthy Horizons) | VA | prior auth required | Jul 1, 2025 | Humana Healthy Horizons® in Virginia Long-Term Services and Supports (LTSS) Prior Authorization and Notification List | |
| Molina Complete Care (Virginia) | Virginia state exceptions to the national Medicaid grid (exceptions only) | VA | prior auth required | State exception | Apr 1, 2025 | Virginia Medicaid PA Code Matrix and Virginia code/benefit exceptions, effective Q2 2025 |
| Molina Complete Care (Virginia) | Medicaid | VA | prior auth required | State exception | Apr 1, 2025 | Virginia Medicaid PA Code Matrix and Virginia code/benefit exceptions, effective Q2 2025 |
| Molina Healthcare of California | Medicaid | CA | prior auth required | State exception | Apr 1, 2026 | Medicaid Prior Auth (PA) Code Matrix (California), effective Q2 2026 |
| Molina Healthcare of Idaho | Medicaid | ID | prior auth required | State exception; Codes are covered for LTSS plans only | Jan 1, 2025 | Idaho Medicaid Prior Auth (PA) Code Matrix and Idaho code/benefit exceptions, Q1 2025 |
| Molina Healthcare of Iowa | Medicaid | IA | prior auth required | Jul 1, 2023 | IA Prior Authorization Matrix, effective Q3 2023 | |
| Molina Healthcare of Texas | STAR | TX | prior auth required | Feb 19, 2025 | Molina Healthcare of Texas Prior Authorization Annual Review Report (STAR), reviewed 2025-02-19 | |
| Molina Healthcare of Texas | STAR+PLUS | TX | prior auth required | Feb 19, 2025 | Molina Healthcare of Texas Prior Authorization Annual Review Report (STAR+PLUS), reviewed 2025-02-19 | |
| Molina Healthcare of Texas | STAR, STAR+PLUS, STAR Kids, CHIP (Medicaid PA code matrix) | TX | prior auth required | Feb 1, 2022 | Medicaid Behavioral Health and Medical Prior Authorization (PA) Code Matrix (Texas), 2026-Q3 | |
| UnitedHealthcare Community Plan | Massachusetts Senior Care Options (SCO) and OneCare | MA | prior auth required | Oct 1, 2026 | Prior authorization requirements for Massachusetts MA SCO OneCare Effective October 1, 2026 |
S5161 appears in 2 coverage policies from Aetna, Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Safety Items (0623) | not covered | Sep 23, 2026 | payer document |
| Premera Blue Cross | Non-covered Services and Procedures Page | 19 of 30 | ∞ | not covered | Jun 1, 2026 | payer document |
Prior authorization required or conditional in CO, IN, MA, 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.