36575 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 36575

Payer coverage policies that name 36575

36575 appears in 8 coverage policies from Aetna.

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
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
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

Medicaid fee-for-service

  • AZ: $206.17 (asc), effective Oct 1, 2026
  • CO: $37.09 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $23.12 (physician, facility), effective Jan 1, 2026
  • IL: $32.27 (practitioner), effective Apr 1, 2024
  • IN: $25.70 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $157.07 (asc, facility), effective Jan 1, 2004
  • KY: $336.36 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $270.80 (asc), effective May 1, 2026
  • MS: $265.85 (comprehensive, facility), effective Oct 1, 2025
  • ND: $198.29 (physician, facility), effective Aug 1, 2026
  • NE: $413.00 (asc), effective Jul 1, 2024
  • NY: $80.80 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $28.68 (physician, facility), effective Jan 1, 2024
  • OK: $306.87 (asc), effective Jan 1, 2026
  • TX: $223.75 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $25.75 (medical, facility), effective Jul 1, 2026
  • VT: $487.08 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $277.42 (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.