CPT 62381 ·
62381
62381 (62381) — payor coverage and prior-authorization requirements across all Medicare MACs, commercial payors, BCBS plans, and Medicaid programs tracked by Rubrica.
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Rubrica tracks payor coverage for CPT 62381 (62381) across 3 payors — every Medicare MAC, the major commercial plans, the BCBS family, all 50-state Medicaid programs, and selected workers' comp and auto/PIP carriers. Aggregate coverage patterns are shown below; full payor-specific criteria, source citations, and last-reviewed dates are available to signed-in practitioners.
Top payors covering CPT 62381
Sample of 12 payors with coverage for this code. Sign in for the complete payor list, verbatim criteria, denial-risk score, and source citations for each.
| Payor | Coverage | Prior auth |
|---|---|---|
| Georgia Medicaid | Covered | Prior auth |
| Illinois Medicaid (HFS) | Covered | Prior auth |
| New York Medicaid | Covered | Prior auth |
Coverage themes for CPT 62381
Common patterns across the 3 payors we track. Specific criteria per payor are available after sign-in.
Conservative care requirements vary by payor for 62381.
2 of 3 payors require imaging concordance documentation.
Of the 3 payors with coverage records for CPT 62381, 1 require prior authorization, 2 cover without prior authorization, and 0 flag the procedure as investigational or experimental under current criteria.
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