27259 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 27259

Payer coverage policies that name 27259

27259 appears in 4 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaIntraoperative Neurophysiological Monitoring (0697)not covered (range 26990-27299)Jun 19, 2026payer document
AetnaNerve Blocks (0863)listed, no stance (range 26990-27299)Jul 23, 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: $1303.19 (asc), effective Oct 1, 2026
  • CO: $1226.80 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $1089.22 (physician, non-facility), effective Jan 1, 2026
  • IL: $1068.56 (practitioner), effective Apr 1, 2024
  • IN: $1179.19 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $971.26 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $1058.92 (physician, facility), effective Jan 1, 2026
  • LA: $249.78 (professional), effective Jul 1, 2025
  • MA: $1149.53 (physician_surgery), effective May 1, 2024
  • MS: $1162.52 (comprehensive), effective Jul 1, 2026
  • ND: $1199.25 (physician, facility), effective Aug 1, 2026
  • NE: $1407.90 (physician, non-facility), effective Jul 1, 2026
  • NY: $745.05 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $1093.07 (physician), effective Jan 1, 2024
  • OK: $1229.36 (physician, non-facility), effective Jul 1, 2026
  • TX: $184.15 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2026
  • VA: $1213.25 (medical), effective Jul 1, 2026
  • VT: $2540.58 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $819.82 (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.