21343 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 21343

Payer coverage policies that name 21343

21343 appears in 3 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaGeneral Anesthesia and Monitored Anesthesia Care for Oral and Maxillofacial Surgery and Dental Services (0124)covered if criteria are met (range 21295-21497)Mar 19, 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

Medicaid fee-for-service

  • AZ: $2519.24 (asc), effective Oct 1, 2026
  • CO: $881.67 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $758.01 (physician, non-facility), effective Jan 1, 2026
  • IL: $898.95 (practitioner), effective Jul 1, 2026
  • IN: $837.57 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $457.28 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $627.26 (physician, facility), effective Jan 1, 2026
  • LA: $174.16 (professional), effective Jul 1, 2025
  • MA: $829.39 (physician_surgery), effective May 1, 2024
  • MS: $805.84 (comprehensive), effective Jul 1, 2026
  • ND: $2346.61 (physician, facility), effective Aug 1, 2026
  • NE: $1037.40 (physician, non-facility), effective Jul 1, 2026
  • NY: $563.13 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $666.04 (physician), effective Jan 1, 2024
  • OK: $854.19 (physician, non-facility), effective Jul 1, 2026
  • TX: $135.55 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), facility), effective Mar 1, 2026
  • VA: $844.33 (medical), effective Jul 1, 2026
  • VT: $4596.52 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $581.52 (physician, facility), effective Jul 1, 2026
  • WY: $2617.97 (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.