Payer policies › CPT 2303123031 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 23031 Payer coverage policies that name 23031 23031 appears in 6 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Continuous Passive Motion (CPM) Machines (0010) listed, no stance (range 23000-23921) Mar 5, 2026 payer document Aetna Infusion Pumps (0161) listed, no stance (range 23000-23921) Mar 31, 2026 payer document Aetna Intraoperative Neurophysiological Monitoring (0697) not covered (range 23000-23929) Jun 19, 2026 payer document Aetna Nerve Blocks (0863) listed, no stance (range 23000-23929) Jul 23, 2026 payer 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
Medicaid fee-for-service AZ: $751.83 (asc), effective Oct 1, 2026 CO: $179.54 (chp_plus, non-facility), effective Jul 1, 2026 FL: $167.81 (physician, facility), effective Jan 1, 2026 IL: $153.27 (practitioner), effective Apr 1, 2024 IN: $172.66 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $264.76 (default, Exempt Physician), effective Aug 1, 2024 KY: $1218.59 (asc), effective Jan 1, 2026 LA: $217.00 (asc), effective Jul 1, 2012 MA: $845.19 (asc), effective May 1, 2026 MS: $961.52 (comprehensive, facility), effective Oct 1, 2025 ND: $718.36 (physician, facility), effective Aug 1, 2026 NE: $552.00 (asc), effective Jul 1, 2024 NY: $107.26 (physician_surgery, facility), effective Jul 1, 2026 OH: $112.65 (physician, facility), effective Jan 1, 2024 OK: $1111.74 (asc), effective Jan 1, 2026 TX: $815.20 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023 VA: $186.92 (medical, facility), effective Jul 1, 2026 VT: $2255.40 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $339.40 (asc), effective Jul 1, 2026 WY: $1284.57 (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.