15260 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 15260

Payer coverage policies that name 15260

15260 appears in 2 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBeremagene Geperpavec-svdt (Vyjuvek) (1033)listed, no stance (range 15040-15261)Jun 12, 2026payer document
AetnaSkin and Soft Tissue Substitutes (0244)covered if criteria are met (range 15050-15261)Jul 29, 2026payer document
AetnaSkin and Soft Tissue Substitutes (0244)not covered (range 10040-19499)Jul 29, 2026payer document

Medicaid fee-for-service

  • AZ: $662.63 (asc), effective Oct 1, 2026
  • CO: $752.93 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $587.81 (physician, facility), effective Jan 1, 2026
  • IL: $568.34 (practitioner), effective Apr 1, 2024
  • IN: $656.84 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $335.00 (asc, facility), effective Aug 1, 1982
  • KY: $1101.65 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $696.96 (asc), effective May 1, 2026
  • MS: $784.87 (comprehensive, facility), effective Oct 1, 2025
  • ND: $649.43 (physician, facility), effective Aug 1, 2026
  • NE: $413.00 (asc), effective Jul 1, 2024
  • NY: $394.27 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $426.52 (physician, facility), effective Jan 1, 2024
  • OK: $1005.06 (asc), effective Jan 1, 2026
  • TX: $709.01 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $630.21 (medical, facility), effective Jul 1, 2026
  • VT: $1602.06 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $912.46 (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.