Payer policies › CPT 1526115261 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 15261 Payer coverage policies that name 15261 15261 appears in 2 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Beremagene Geperpavec-svdt (Vyjuvek) (1033) listed, no stance (range 15040-15261) Jun 12, 2026 payer document Aetna Skin and Soft Tissue Substitutes (0244) covered if criteria are met (range 15050-15261) Jul 29, 2026 payer document Aetna Skin and Soft Tissue Substitutes (0244) not covered (range 10040-19499) Jul 29, 2026 payer document
Medicaid fee-for-service AZ: $70.44 (outpatient_hospital, RF133), effective Oct 1, 2025 CO: $134.26 (chp_plus, non-facility), effective Jul 1, 2026 FL: $92.61 (physician, facility), effective Jan 1, 2026 IN: $102.98 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $247.87 (asc, facility), effective Aug 1, 1982 KY: $0.00 (asc), effective Jan 1, 2026 LA: $182.30 (asc), effective Jul 1, 2012 MA: $0.00 (asc), effective May 1, 2026 MS: $168.70 (comprehensive), effective Jul 1, 2026 ND: $226.80 (physician), effective Aug 1, 2026 NE: $413.00 (asc), effective Jul 1, 2024 NY: $68.71 (physician_surgery, facility), effective Jul 1, 2026 OH: $107.31 (physician, facility), effective Jan 1, 2024 OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026 TX: $98.86 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2025 VA: $97.51 (medical, facility), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $65.93 (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.