38530 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 38530

Payer coverage policies that name 38530

38530 appears in 3 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaNerve Blocks (0863)listed, no stance (range 38500-38531)Jul 23, 2026payer document
AetnaPositron Emission Tomography (PET) (0071)listed, no stance (range 38500-38530)Sep 14, 2026payer document
AetnaTumor Scintigraphy (0168)covered if criteria are metMar 27, 2026payer document

Medicaid fee-for-service

  • AZ: $995.48 (asc), effective Oct 1, 2026
  • CO: $261.89 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $412.78 (physician, non-facility), effective Jan 1, 2026
  • IL: $392.36 (practitioner), effective Apr 1, 2024
  • IN: $435.79 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $350.00 (asc, facility), effective Aug 1, 1982
  • KY: $1564.94 (asc), effective Jan 1, 2026
  • LA: $217.00 (asc), effective Jul 1, 2012
  • MA: $950.67 (asc), effective May 1, 2026
  • MS: $1230.44 (comprehensive, facility), effective Oct 1, 2025
  • ND: $922.54 (physician, facility), effective Aug 1, 2026
  • NE: $637.00 (asc), effective Jul 1, 2024
  • NY: $251.22 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $299.40 (physician), effective Jan 1, 2024
  • OK: $1427.73 (asc), effective Jan 1, 2026
  • TX: $963.66 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $459.78 (medical), effective Jul 1, 2026
  • VT: $3040.18 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), effective Jul 1, 2026
  • WY: $1731.55 (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.