36558 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 36558

Payer coverage policies that name 36558

36558 appears in 11 coverage policies from Aetna, BlueCross BlueShield of South Carolina.

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
AetnaIntestinal Transplantation (0605)listed, no stance (range 36555-36597)Sep 3, 2026payer document
AetnaLurbinectedin (Zepzelca) (0978)listed, no stanceMar 11, 2026payer document
AetnaNegative Pressure Wound Therapy (0334)listed, no stance (range 33016-37799)Jun 8, 2026payer document
AetnaNitric Oxide, Inhalational (INO) (0518)not covered (range 33016-37790)Jul 2, 2026payer document
AetnaNutritional Support (0061)listed, no stance (range 36555-36571)Jan 15, 2026payer document
AetnaStereolithographic Models and Implants (0613)listed, no stance (range 33010-37790)Sep 3, 2026payer document
AetnaUltrasound Guidance – Selected Indications (0952)covered if criteria are metApr 27, 2026payer document
BlueCross BlueShield of South CarolinaTotal Parenteral Nutrition and Enteral Nutrition in the Home (CAM 10201)listed, no stance (range 36555-36571)Jun 1, 2026payer document

Medicaid fee-for-service

  • AZ: $1188.60 (asc), effective Oct 1, 2026
  • CO: $215.65 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $819.27 (pediatric_surgery, pediatric surgeon), effective Jan 1, 2025
  • IL: $175.64 (practitioner), effective Apr 1, 2024
  • IN: $196.96 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $367.50 (asc, facility), effective Jan 1, 2004
  • KY: $1584.96 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $1140.05 (asc), effective May 1, 2026
  • MS: $1270.95 (comprehensive, facility), effective Oct 1, 2025
  • ND: $934.34 (physician, facility), effective Aug 1, 2026
  • NE: $637.00 (asc), effective Jul 1, 2024
  • NY: $144.43 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $197.47 (physician, facility), effective Jan 1, 2024
  • OK: $1446.00 (asc), effective Jan 1, 2026
  • TX: $1118.22 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $201.39 (medical, facility), effective Jul 1, 2026
  • VT: $2451.66 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), effective Jul 1, 2026
  • WY: $1396.35 (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.