21600 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 21600

2 of 2 payer prior-auth lists that name 21600 require prior authorization or set conditions: Blue Shield of California.

PayerPlanStatePrior authConditionsSinceSource
Blue Shield of CaliforniaBlue Shield MedicareCAprior auth requiredSep 1, 2026Prior Authorization List for Blue Shield Medicare
Blue Shield of CaliforniaBlue Shield commercialCAprior auth requiredSep 1, 2026Prior Authorization List for Blue Shield

Payer coverage policies that name 21600

21600 appears in 5 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Shield of California.

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
Blue Cross & Blue Shield of MississippiTransurethral Microwave Thermotherapy Tumt (L.7.01.426)covered if criteria are metpayer document
Blue Shield of CaliforniaBSC7.21 | Rib Remodeling and Clavicle Shorteninglisted, no stancepayer document
Blue Shield of CaliforniaBSC7.21 | Skeletal Remodelinglisted, no stancepayer document

Medicaid fee-for-service

  • AZ: $3026.13 (asc), effective Oct 1, 2026
  • CO: $454.18 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $441.61 (physician, non-facility), effective Jan 1, 2026
  • IL: $391.83 (practitioner), effective Apr 1, 2024
  • IN: $438.51 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $300.00 (asc, facility), effective Aug 1, 1982
  • KY: $3607.39 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $2382.86 (asc), effective May 1, 2026
  • MS: $2808.67 (comprehensive, facility), effective Oct 1, 2025
  • ND: $2126.56 (physician, facility), effective Aug 1, 2026
  • NE: $785.00 (asc), effective Jul 1, 2024
  • NY: $262.58 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $361.50 (physician), effective Jan 1, 2024
  • OK: $3291.10 (asc), effective Jan 1, 2026
  • TX: $2398.52 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $491.90 (medical), effective Jul 1, 2026
  • VT: $5634.17 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $366.60 (asc), effective Jul 1, 2026
  • WY: $3208.96 (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.