Payer policies › CPT 3640536405 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 36405 Payer coverage policies that name 36405 36405 appears in 6 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Anesthetic and Antiemetic Infusion Pumps (0607) listed, no stance (range 33016-37799) Sep 9, 2026 payer document Aetna Bupivacaine Liposome (Exparel) (0941) listed, no stance (range 33010-37799) Jul 30, 2026 payer document Aetna Cardiovascular Ultrafiltration (0741) listed, no stance (range 33010-37790) Oct 30, 2025 payer document Aetna Negative Pressure Wound Therapy (0334) listed, no stance (range 33016-37799) Jun 8, 2026 payer document Aetna Nitric Oxide, Inhalational (INO) (0518) not covered (range 33016-37790) Jul 2, 2026 payer document Aetna Stereolithographic Models and Implants (0613) listed, no stance (range 33010-37790) Sep 3, 2026 payer document
Medicaid fee-for-service AZ: $9.42 (outpatient_hospital, RF133), effective Oct 1, 2025 CO: $18.69 (chp_plus, non-facility), effective Jul 1, 2026 IL: $14.34 (practitioner), effective Apr 1, 2024 IN: $11.58 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $14.84 (default, Exempt Physician), effective Aug 1, 2024 KY: $0.00 (asc), effective Jan 1, 2026 LA: $19.05 (professional), effective Jul 1, 2025 MA: $0.00 (asc), effective May 1, 2026 MS: $11.02 (comprehensive), effective Jul 1, 2026 ND: $26.66 (physician), effective Aug 1, 2026 NE: $30.00 (physician, facility), effective Jul 1, 2026 NY: $12.12 (physician_surgery, facility), effective Jul 1, 2026 OH: $9.39 (physician, facility), effective Dec 31, 2013 OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026 TX: $9.82 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), facility), effective Sep 1, 2026 VA: $11.00 (medical, facility), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $7.45 (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.