S9055 Procuren or other growth facProcuren or other growth factor preparation to promote wound healing
Status I: not valid for Medicare (Medicare uses another code).
1 of 1 payer prior-auth lists that name S9055 require prior authorization or set conditions: Rocky Mountain Health Plans.
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Rocky Mountain Health Plans | Rocky Mountain Health Plans CHP+ | CO | prior auth required | Oct 1, 2026 | Rocky Mountain Children’s Health Plan - prior authorization Effective October 1, 2026 |
S9055 appears in 10 coverage policies from Aetna, Blue Shield of California, BlueCross BlueShield of South Carolina, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, Regence.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Blood and Adipose Tissue Derived Products for Selected Indications (0784) | not covered | Nov 19, 2025 | payer document |
| Aetna | Bone and Tendon Graft Substitutes and Adjuncts (0411) | not covered | Aug 18, 2026 | payer document |
| Aetna | Distraction Osteogenesis for Craniofacial Defects (0549) | not covered | Jul 30, 2026 | payer document |
| Aetna | Septoplasty and Rhinoplasty (0005) Spirox Latera Absorbable Nasal Implant | not covered | Mar 12, 2026 | payer document |
| Aetna | Skin and Soft Tissue Substitutes (0244) | not covered | Jul 29, 2026 | payer document |
| Blue Shield of California | Autologous Platelet-Derived Growth Factors for Wound Healing and Other Non-Orthopedic Conditions (2.01.16) | listed, no stance | payer document | |
| BlueCross BlueShield of South Carolina | Recombinant and Autologous Platelet-Derived Growth Factors for Wound Healing and Other Non-Orthopedic Conditions (CAM 20116) | listed, no stance | Sep 1, 2026 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Recombinant and Autologous Platelet-Derived Growth Factors for Wound Healing and Other Non-Orthopedic Conditions (RX501.034) | listed, no stance | Apr 15, 2026 | payer document |
| Premera Blue Cross | Recombinant and Autologous Platelet-Derived Growth Factors for Wound Healing and Other Non-Orthopedic Conditions (2.01.543) | listed, no stance | Mar 9, 2026 | payer document |
| Regence | Autologous Blood-Derived Growth Factors as a Treatment for Wound Healing and Other Miscellaneous Conditions (Medicine 77) | listed, no stance | Nov 1, 2025 | payer document |
Prior authorization required or conditional in IN.
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.