CPT 93321: Conducting a follow-up ultrasound assessment of the heart's valves, chambers, and blood flow - Prior Authorization and Price

Payer guidelines that apply

Guidelines collected from the payers' published documents on September 29, 2026. Payers revise these documents during the year. Open the guideline link to confirm the current version before you submit.

Conditions the guidelines address for this study

These are the clinical situations where payer guidelines discuss Conducting a follow-up ultrasound assessment of the heart's valves, chambers, and blood flow. Each has its own criteria for when the study is considered appropriate.

• Established bicuspid aortic valve Anthem BCBS
• Established flow-limiting CAD in asymptomatic patients Anthem BCBS
• Established flow-limiting CAD in patients who have new or worsening symptoms Anthem BCBS
• Established mitral valve prolapse Anthem BCBS
• Established native valvular regurgitation Anthem BCBS
• Established native valvular stenosis (does not apply to congenital valvular stenosis) Anthem BCBS
• Established or suspected CAD Anthem BCBS
• Established valvular heart disease – patients who have undergone valve intervention (replacement or repair) Anthem BCBS
• Evaluation of aortic disease Anthem BCBS
• Evaluation of cardiac masses or cardiac source of embolus Anthem BCBS
• Evaluation of infective endocarditis (native or prosthetic valves) Anthem BCBS
• Evaluation of patients with cardiac arrhythmias Anthem BCBS
• Evaluation of patients with congenital heart disease Anthem BCBS
• Evaluation of patients with known CAD Anthem BCBS
• Evaluation of patients with pulmonary embolus Anthem BCBS
• Evaluation of patients with pulmonary hypertension Anthem BCBS
• Evaluation of patients with suspected CAD Anthem BCBS
• Evaluation of pericardial diseases Anthem BCBS
• Evaluation of signs, symptoms, or abnormal testing Anthem BCBS
• Evaluation of suspected or established Kawasaki disease Anthem BCBS
• Evaluation of ventricular function Anthem BCBS
• Hypertrophic obstructive cardiomyopathy Anthem BCBS
• Indications are organized as follows Anthem BCBS
• Patients who have had, or are likely to have, suboptimal transthoracic imaging Anthem BCBS
• Pulmonary hypertension Anthem BCBS
• Suspected CAD in symptomatic patients who have not had evaluation for CAD within the preceding 60 days Anthem BCBS
• Suspected valvular heart disease Anthem BCBS
• Valvular heart disease Anthem BCBS
• Screening Imaging in Cancer Predisposition Syndromes Aetna · Cigna · UnitedHealthcare

Typical price

Commercial figures come from negotiated rates published by 773 hospitals; Medicare figures from CMS fee schedules. Rates vary widely by hospital and plan. Pricing data from CenterIQ.