Payer policies › CPT 2905529055 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 29055 Payer coverage policies that name 29055 29055 appears in 3 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Orthopedic Casts, Braces and Splints (0009) covered if criteria are met (range 29000-29584) Jan 20, 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: $84.24 (asc), effective Oct 1, 2026 CO: $63.60 (chp_plus, non-facility), effective Jul 1, 2026 FL: $102.09 (physician, facility), effective Jan 1, 2026 IL: $115.80 (practitioner), effective Jul 1, 2026 IN: $106.48 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $122.48 (default, Exempt Physician), effective Aug 1, 2024 KY: $149.96 (asc), effective Jan 1, 2026 LA: $180.05 (professional), effective Jul 1, 2025 MA: $98.70 (asc), effective May 1, 2026 MS: $114.02 (comprehensive, facility), effective Oct 1, 2025 ND: $88.40 (physician, facility), effective Aug 1, 2026 NE: $19.72 (physician, facility), effective Jul 1, 2026 NY: $64.26 (physician_surgery, facility), effective Jul 1, 2026 OH: $55.49 (physician, facility), effective Jan 1, 2014 OK: $114.23 (physician, facility), effective Jul 1, 2026 TX: $99.86 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023 VA: $113.72 (medical, facility), effective Jul 1, 2026 VT: $217.17 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $77.97 (physician, facility), effective Jul 1, 2026 WY: $123.69 (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.