Payer policies › CPT 3879438794 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 38794 Medicaid fee-for-service AZ: $290.09 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 FL: $201.06 (physician, non-facility), effective Jan 1, 2026 IN: $218.87 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $183.19 (default, Exempt Physician), effective Aug 1, 2024 KY: $0.00 (asc), effective Jan 1, 2026 LA: $241.53 (professional), effective Feb 1, 2013 MA: $0.00 (asc), effective May 1, 2026 MS: $217.19 (comprehensive), effective Jul 1, 2026 ND: $278.99 (physician), effective Aug 1, 2026 NE: $76.93 (physician, non-facility), effective Jul 1, 2026 OH: $196.98 (physician), effective Jan 1, 2024 OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026 TX: $217.24 (physician, Physician, facility), effective Sep 1, 2026 VA: $223.96 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $153.07 (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.