Payer policies › CPT 1003510035 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 10035 Medicaid fee-for-service Prior authorization required or conditional in KY.
AZ: $273.00 (outpatient_hospital, RF133), effective Oct 1, 2025 CO: $106.88 (chp_plus, non-facility), effective Jul 1, 2026 FL: $56.99 (physician, facility), effective Jan 1, 2026 IL: $56.89 (practitioner), effective Apr 1, 2024 IN: $64.59 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $157.90 (default, Exempt Physician), effective Aug 1, 2024 KY: $0.00 (asc), effective Jan 1, 2026 LA: $368.18 (professional), effective Jan 1, 2016 MA: $0.00 (asc), effective May 1, 2026 MS: $61.44 (comprehensive), effective Jul 1, 2026 ND: $384.50 (physician), effective Aug 1, 2026 NE: $140.78 (physician, non-facility), effective Jul 1, 2026 NY: $47.87 (physician_surgery, facility), effective Jul 1, 2026 OH: $70.14 (physician, facility), effective Jan 1, 2024 OK: $64.42 (physician, facility), effective Jul 1, 2026 TX: $66.02 (physician, Physician, facility), effective Mar 1, 2025 VA: $61.63 (medical, facility), effective Jul 1, 2026 VT: $549.84 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $41.28 (physician, facility), effective Jul 1, 2026 WY: $313.16 (outpatient_hospital_apc, Ambulatory Surgical Centers), effective Apr 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.