33986 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 33986

Payer coverage policies that name 33986

33986 appears in 16 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Shield of California.

PayerPolicyRole in policyReviewedDocument
AetnaAnesthetic and Antiemetic Infusion Pumps (0607)listed, no stance (range 33016-37799)Sep 9, 2026payer document
AetnaBupivacaine Liposome (Exparel) (0941)listed, no stance (range 33010-37799)Jul 30, 2026payer document
AetnaCardiovascular Ultrafiltration (0741)listed, no stance (range 33010-37790)Oct 30, 2025payer document
AetnaCryoanalgesia and Therapeutic Cold (0297)listed, no stance (range 33016-33999)Apr 14, 2026payer document
AetnaExtracorporeal Membrane Oxygenation (ECMO) (0546)covered if criteria are metAug 27, 2026payer document
AetnaFunctional Electrical Stimulation and Neuromuscular Electrical Stimulation (0677)listed, no stance (range 33016-33999)Sep 10, 2026payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 33016-33999)Jul 1, 2026payer document
AetnaNegative Pressure Wound Therapy (0334)listed, no stance (range 33016-37799)Jun 8, 2026payer document
AetnaNerve Blocks (0863)listed, no stance (range 33016-33999)Jul 23, 2026payer document
AetnaNitric Oxide, Inhalational (INO) (0518)not covered (range 33016-37790)Jul 2, 2026payer document
AetnaPalivizumab (Synagis) (0318)listed, no stance (range 33946-33986)Aug 21, 2026payer document
AetnaProcalcitonin (PCT) (0771)listed, no stance (range 33016-33997)Nov 13, 2025payer document
AetnaStereolithographic Models and Implants (0613)listed, no stance (range 33010-37790)Sep 3, 2026payer document
Blue Cross & Blue Shield of MississippiHeartlung Transplantcovered if criteria are metpayer document
Blue Cross Blue Shield of MassachusettsExtracorporeal Membrance Oxygenation (726)listed, no stancepayer document
Blue Shield of CaliforniaExtracorporeal Membrane Oxygenation for Adult Conditions (8.01.60)listed, no stancepayer document

Medicaid fee-for-service

  • AZ: $522.66 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $410.73 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $371.21 (physician, non-facility), effective Jan 1, 2026
  • IL: $366.22 (practitioner), effective Apr 1, 2024
  • IN: $383.73 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $296.39 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $426.22 (physician, facility), effective Jan 1, 2026
  • LA: $494.14 (professional), effective Jan 1, 2015
  • MA: $370.77 (physician_surgery), effective May 1, 2024
  • MS: $401.76 (comprehensive), effective Jul 1, 2026
  • ND: $482.88 (physician), effective Aug 1, 2026
  • NE: $926.24 (physician, non-facility), effective Jul 1, 2026
  • NY: $360.66 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $491.14 (physician), effective Jan 1, 2015
  • OK: $422.96 (physician, non-facility), effective Jul 1, 2026
  • TX: $381.98 (physician, Physician, facility), effective Sep 1, 2026
  • VA: $413.48 (medical, facility), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $271.55 (physician, facility), effective Jul 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.