37195 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 37195

Payer coverage policies that name 37195

37195 appears in 7 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
AetnaCerebral Perfusion Studies (0663)listed, no stanceApr 14, 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

Medicaid fee-for-service

  • AZ: $164.70 (asc), effective Oct 1, 2026
  • CO: $240.56 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $190.26 (physician, non-facility), effective Jan 1, 2026
  • IL: $472.40 (practitioner), effective Jul 1, 2026
  • IN: $281.66 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2024
  • KS: $175.40 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $177.03 (asc), effective Jan 1, 2026
  • LA: $254.46 (professional), effective Feb 1, 2013
  • MS: $250.84 (comprehensive), effective Jul 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • NE: $518.70 (physician, non-facility), effective Jul 1, 2026
  • NY: $176.07 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $124.40 (physician), effective Jan 1, 2016
  • OK: $254.24 (physician, non-facility), effective Jul 1, 2026
  • TX: $248.32 (physician, Physician, facility), effective Sep 1, 2024
  • VA: $191.19 (medical), effective Jul 1, 2026
  • VT: $256.47 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $146.07 (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.