Payer policies › CPT 2052620526 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 20526 2 of 2 payer prior-auth lists that name 20526 require prior authorization or set conditions: Neighborhood Health Partnership, UnitedHealthcare.
Payer Plan State Prior auth Conditions Since Source Neighborhood Health Partnership Neighborhood Health Partnership FL prior auth under conditions site of care: outpatient hospital; not in AK, IL, GU, MA, PR, RI, TX, UT, VI, WI Sep 1, 2026 Prior authorization requirements for Neighborhood Health Partnership Effective September 1, 2026 UnitedHealthcare UnitedHealthcare Complete (Individual & Family plans) All prior auth under conditions site of care: outpatient hospital Sep 1, 2026 Prior authorization requirements for UnitedHealthcare Complete Effective September 1, 2026
Payer coverage policies that name 20526 20526 appears in 3 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Remote Ischemic Conditioning (0814) listed, no stance (range 20000-29999) Nov 20, 2025 payer document Aetna Skin and Soft Tissue Substitutes (0244) not covered (range 20100-29999) Jul 29, 2026 payer document Aetna Ultrasound Guidance – Selected Indications (0952) covered if criteria are met Apr 27, 2026 payer document
Recent prior-auth changes Oct 1, 2026: PA removed, UnitedHealthcare Oct 1, 2026: PA removed, UnitedHealthcare Oct 1, 2026: PA removed, Oxford Health Plans Oct 1, 2026: PA removed, UnitedHealthcare Aug 1, 2026: conditions changed, UnitedHealthcare Jul 1, 2026: conditions changed, UnitedHealthcare Jul 1, 2026: conditions changed, UnitedHealthcare Jul 1, 2026: conditions changed, Neighborhood Health Partnership Jun 1, 2026: conditions changed, UnitedHealthcare Apr 1, 2026: PA removed, UnitedHealthcare Community Plan Medicaid fee-for-service AZ: $28.47 (asc), effective Oct 1, 2026 CO: $64.59 (chp_plus, non-facility), effective Jul 1, 2026 FL: $39.29 (physician, facility), effective Jan 1, 2026 IL: $39.26 (practitioner), effective Apr 1, 2024 IN: $43.44 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $168.00 (asc, facility), effective Jan 1, 2002 KY: $50.79 (asc), effective Jan 1, 2026 LA: $65.47 (professional), effective Jul 1, 2025 MA: $35.28 (asc), effective May 1, 2026 MS: $36.23 (comprehensive, facility), effective Oct 1, 2025 ND: $50.24 (physician, facility), effective Aug 1, 2026 NE: $52.00 (physician, facility), effective Jul 1, 2026 NY: $26.77 (nurse_practitioner, facility), effective Jul 1, 2026 OH: $35.01 (physician, facility), effective Jan 1, 2024 OK: $43.79 (physician, facility), effective Jul 1, 2026 TX: $36.54 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023 VA: $42.82 (medical, facility), effective Jul 1, 2026 VT: $238.34 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $28.67 (physician, facility), effective Jul 1, 2026 WY: $135.74 (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.