S9986 Not medically necessary svc

Not medically necessary service (patient is aware that service not medically necessary)

Medicare pricing for S9986

Physician Fee Schedule (CY 2026, RVU26D)

Status I: not valid for Medicare (Medicare uses another code).

Payer policies and prior authorization for S9986

Payer coverage policies that name S9986

S9986 appears in 1 coverage policy from Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
Premera Blue CrossNon-covered Services and Procedures
Page | 20 of 30 | ∞		not coveredJun 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • ND: $0.00 (physician), effective Aug 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.