20550 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 20550

Payer coverage policies that name 20550

20550 appears in 17 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, BlueCross BlueShield of South Carolina, Capital Blue Cross, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).

PayerPolicyRole in policyReviewedDocument
AetnaBack Pain - Invasive Procedures (0016)not coveredOct 6, 2026payer document
AetnaCollagenase Clostridium Histolyticum (Xiaflex) (1061)listed, no stanceSep 14, 2026payer document
AetnaDupuytren's Contracture Treatments (0800)listed, no stanceNov 20, 2025payer document
AetnaHeadaches: Invasive Procedures (0707)not coveredJul 23, 2026payer document
AetnaNerve Blocks (0863)listed, no stanceJul 23, 2026payer document
AetnaPlantar Fasciitis Treatments (0235)covered if criteria are metApr 27, 2026payer document
AetnaProlotherapy and Sclerotherapy (0207)listed, no stanceMar 27, 2026payer document
AetnaRemote Ischemic Conditioning (0814)listed, no stance (range 20000-29999)Nov 20, 2025payer document
AetnaSkin and Soft Tissue Substitutes (0244)not covered (range 20100-29999)Jul 29, 2026payer document
AetnaUltrasound Guidance – Selected Indications (0952)not coveredApr 27, 2026payer document
Blue Cross & Blue Shield of MississippiFoot Care Services (L.9.01.401)covered if criteria are metpayer document
Blue Cross & Blue Shield of MississippiTrigger Point Injections (L.2.01.405)covered if criteria are metpayer document
Blue Cross & Blue Shield of MississippiXiaflex Collagenase Clostridium Histolyticum (L.5.01.492)listed, no stancepayer document
Blue Cross & Blue Shield of MississippiXiaflex Collagenase Clostridium Histolyticum (S.5.01.492)listed, no stancepayer document
BlueCross BlueShield of South CarolinaProlotherapy (CAM 20126)listed, no stanceMay 1, 2026payer document
Capital Blue CrossNeural Therapy (MP 8.012)
Procedure codes
unproven / investigationalFeb 1, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Prolotherapy (MED201.013)listed, no stanceJun 15, 2025payer document

Medicaid fee-for-service

  • AZ: $18.18 (asc), effective Oct 1, 2026
  • CO: $44.71 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $26.88 (physician, facility), effective Jan 1, 2026
  • IL: $31.75 (podiatrist), effective Oct 1, 2014
  • IN: $30.06 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $168.00 (asc, facility), effective Aug 1, 1982
  • KY: $32.44 (asc), effective Jan 1, 2026
  • LA: $46.18 (professional), effective Jul 1, 2025
  • MA: $22.08 (asc), effective May 1, 2026
  • MS: $23.29 (comprehensive, facility), effective Oct 1, 2025
  • ND: $32.09 (physician, facility), effective Aug 1, 2026
  • NE: $21.98 (physician, facility), effective Jul 1, 2026
  • NY: $18.95 (nurse_practitioner, facility), effective Jul 1, 2026
  • OH: $32.70 (physician, facility), effective Jan 1, 2024
  • OK: $29.59 (asc), effective Jan 1, 2026
  • TX: $23.54 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $28.94 (medical, facility), effective Jul 1, 2026
  • VT: $238.34 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $19.49 (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.