20822 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 20822

Payer coverage policies that name 20822

20822 appears in 2 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
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

Medicaid fee-for-service

  • AZ: $504.49 (asc), effective Oct 1, 2026
  • CO: $748.26 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $1246.38 (physician, non-facility), effective Jan 1, 2026
  • IL: $1225.93 (practitioner), effective Apr 1, 2024
  • IN: $1351.19 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $1900.00 (asc, facility), effective Aug 1, 1982
  • KY: $852.05 (asc), effective Jan 1, 2026
  • LA: $1461.38 (professional), effective Feb 1, 2013
  • MA: $606.05 (asc), effective May 1, 2026
  • MS: $670.63 (comprehensive, facility), effective Oct 1, 2025
  • ND: $502.29 (physician, facility), effective Aug 1, 2026
  • NE: $637.00 (asc), effective Jul 1, 2024
  • NY: $1047.62 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $1433.36 (physician), effective Jan 1, 2000
  • OK: $1406.82 (physician, non-facility), effective Jul 1, 2026
  • TX: $593.04 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $1388.31 (medical), effective Jul 1, 2026
  • VT: $1248.54 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $711.11 (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.