Payer policies › CPT 1100511005 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 11005 Payer coverage policies that name 11005 11005 appears in 3 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Negative Pressure Wound Therapy (0334) listed, no stance (range 11000-11047) Jun 8, 2026 payer document Aetna Skin and Soft Tissue Substitutes (0244) not covered (range 10040-19499) Jul 29, 2026 payer document Aetna Wound Care: Home or Outpatient Setting (1054) listed, no stance (range 11000-11047) Dec 23, 2025 payer document
Medicaid fee-for-service AZ: $780.67 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $599.28 (chp_plus, non-facility), effective Jul 1, 2026 FL: $538.76 (physician, non-facility), effective Jan 1, 2026 IL: $545.23 (practitioner), effective Apr 1, 2024 IN: $573.49 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $200.00 (asc, facility), effective Jan 1, 2005 KY: $574.70 (physician, facility), effective Jan 1, 2026 LA: $629.80 (professional), effective Jul 1, 2025 MA: $557.85 (physician_surgery), effective May 1, 2024 MS: $581.92 (comprehensive), effective Jul 1, 2026 ND: $701.79 (physician), effective Aug 1, 2026 NE: $904.02 (physician, non-facility), effective Jul 1, 2026 NY: $359.46 (physician_surgery, facility), effective Jul 1, 2026 OH: $593.90 (physician), effective Jan 1, 2024 OK: $613.14 (physician, non-facility), effective Jul 1, 2026 TX: $613.46 (physician, Physician, facility), effective Mar 1, 2025 VA: $600.12 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $394.81 (physician, facility), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.