Payer policies › CPT 4182141821 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 41821 Payer coverage policies that name 41821 41821 appears in 1 coverage policy from Regence.
Payer Policy Role in policy Reviewed Document Regence Administrative Guidelines to Determine Dental vs Medical Services (Allied Health 35) listed, no stance Jan 1, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in ND, VA.
AZ: $396.13 (asc), effective Oct 1, 2026 CO: $58.75 (chp_plus, non-facility), effective Jul 1, 2026 FL: $83.84 (physician, non-facility), effective Jan 1, 2026 IL: $71.60 (practitioner), effective Jul 1, 2026 IN: $0.00 (professional, facility), effective Jan 1, 2010 KS: $26.25 (default, Exempt Physician), effective Jul 1, 1987 KY: $643.45 (asc), effective Jan 1, 2026 LA: $141.66 (professional), effective Feb 1, 2013 MA: $456.11 (asc), effective May 1, 2026 MS: $525.90 (comprehensive, facility), effective Oct 1, 2025 ND: $379.31 (physician, facility), effective Aug 1, 2026 NE: $59.28 (physician, non-facility), effective Jul 1, 2026 OK: $0.00 (physician, non-facility), effective Jul 1, 2026 TX: $33.33 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VT: $1204.74 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $308.28 (asc), effective Jul 1, 2026 WY: $686.17 (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.