29065 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 29065

1 of 1 payer prior-auth lists that name 29065 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross and Blue Shield of TexasTexas PA exemption (gold card), outpatient, fully insuredTXprior auth requiredGold-card exemption availableJul 1, 2026BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range)

Payer coverage policies that name 29065

29065 appears in 4 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBone and Tendon Graft Substitutes and Adjuncts (0411)listed, no stance (range 29065-29085)Aug 18, 2026payer document
AetnaOrthopedic Casts, Braces and Splints (0009)covered if criteria are met (range 29000-29584)Jan 20, 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: $40.77 (asc), effective Oct 1, 2026
  • CO: $78.44 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $50.14 (physician, facility), effective Jan 1, 2026
  • IL: $59.45 (practitioner), effective Jul 1, 2026
  • IN: $52.67 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $200.00 (asc, facility), effective Aug 1, 1982
  • KY: $72.74 (asc), effective Jan 1, 2026
  • LA: $77.70 (professional), effective Jul 1, 2025
  • MA: $51.23 (asc), effective May 1, 2026
  • MS: $51.50 (comprehensive, facility), effective Oct 1, 2025
  • ND: $71.95 (physician, facility), effective Aug 1, 2026
  • NE: $43.85 (physician, facility), effective Jul 1, 2026
  • NY: $32.98 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $54.34 (physician, facility), effective Jan 1, 2016
  • OK: $56.13 (physician, facility), effective Jul 1, 2026
  • TX: $49.28 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $55.84 (medical, facility), effective Jul 1, 2026
  • VT: $217.17 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $38.41 (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.