Payer policies › CPT 3690936909 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 36909 Payer coverage policies that name 36909 36909 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: $1607.02 (outpatient_hospital, RF133), effective Oct 1, 2025 CO: $104.01 (chp_plus, non-facility), effective Jul 1, 2026 FL: $136.64 (physician, facility), effective Jan 1, 2026 IL: $137.80 (practitioner), effective Apr 1, 2024 IN: $149.46 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $805.50 (default, Exempt Physician), effective Aug 1, 2024 KY: $0.00 (asc), effective Jan 1, 2026 LA: $1603.52 (professional), effective Jan 1, 2017 MA: $0.00 (asc), effective May 1, 2026 MS: $1423.12 (comprehensive), effective Jul 1, 2026 ND: $2027.28 (physician), effective Aug 1, 2026 NE: $154.12 (physician, non-facility), effective Jul 1, 2026 NY: $99.59 (physician_surgery, facility), effective Jul 1, 2026 OH: $152.27 (physician, facility), effective Jan 1, 2024 OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026 TX: $135.82 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $152.20 (medical, facility), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $100.71 (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.