Payer policies › CPT 2725327253 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 27253 Payer coverage policies that name 27253 27253 appears in 4 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Intraoperative Neurophysiological Monitoring (0697) not covered (range 26990-27299) Jun 19, 2026 payer document Aetna Nerve Blocks (0863) listed, no stance (range 26990-27299) 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: $1062.88 (asc), effective Oct 1, 2026 CO: $752.78 (chp_plus, non-facility), effective Jul 1, 2026 FL: $676.44 (physician, non-facility), effective Jan 1, 2026 IL: $651.06 (practitioner), effective Apr 1, 2024 IN: $721.49 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $383.08 (default, Exempt Physician), effective Aug 1, 2024 KY: $755.25 (physician, facility), effective Jan 1, 2026 LA: $761.63 (professional), effective Jul 1, 2025 MA: $706.21 (physician_surgery), effective May 1, 2024 MS: $718.96 (comprehensive), effective Jul 1, 2026 ND: $946.52 (physician, facility), effective Aug 1, 2026 NE: $251.53 (physician, non-facility), effective Jul 1, 2026 NY: $459.68 (physician_surgery, facility), effective Jul 1, 2026 OH: $736.17 (physician), effective Jan 1, 2024 OK: $761.26 (physician, non-facility), effective Jul 1, 2026 TX: $112.65 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2026 VA: $753.47 (medical), effective Jul 1, 2026 VT: $2540.58 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $511.57 (physician, facility), effective Jul 1, 2026 WY: $1447.00 (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.