Molina Healthcare Texas policy
Prescription Digital Therapeutics
Prescription Digital Therapeutics is a public Molina Healthcare Texas policy (policy 412, effective Jun 10, 2026). It lists 20 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
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- Policy number
- 412
- Effective
- Jun 10, 2026
- Line of business
- Commercial, Medicaid
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Open official prior authorization lists to check the member’s product.
| Code | Other Molina Healthcare Texas policies |
|---|---|
| 0687T | Policies naming 0687T |
| 0688T | Policies naming 0688T |
| 0704T | Policies naming 0704T |
| 0705T | Policies naming 0705T |
| 0706T | Policies naming 0706T |
| 0740T | Policies naming 0740T |
| 0741T | Policies naming 0741T |
| 99199 | Policies naming 99199 |
| A9291 | Policies naming A9291 |
| A9292 | Policies naming A9292 |
| A9293 | Policies naming A9293 |
| A9294 | Policies naming A9294 |
| A9999 | Policies naming A9999 |
| E1399 | Policies naming E1399 |
| E1905 | Policies naming E1905 |
| G0552 | Policies naming G0552 |
| G0553 | Policies naming G0553 |
| G0554 | Policies naming G0554 |
| S9002 | Policies naming S9002 |
| T1505 | Policies naming T1505 |
All Molina Healthcare Texas policies · Molina Healthcare Texas prior authorization CPT list