Category III CPT Codes
Policy provides UnitedHealthcare Medicare Advantage guidance for coverage conclusions for AMA Category III CPT codes when no applicable Medicare NCD/LCD/LCA or specific UnitedHealthcare policy exists, listing individual Category III codes with descriptions, CMS NCD/LCD/LCA coverage criteria, and a coverage conclusion or referral to another UnitedHealthcare policy.
Revised list of applicable CPT codes and removed content/language addressing specific Category III codes for vertebral body tethering and revision/replacement/removal codes.
Updated list of Centers for Medicare & Medicaid Services (CMS) related documents available in the Medicare Coverage Database.
Archived previous policy version MMP043.46.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.