41830 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 41830

1 of 1 payer prior-auth lists that name 41830 require prior authorization or set conditions: Humana.

PayerPlanStatePrior authConditionsSinceSource
HumanaHumana Puerto Rico MA and Dual Medicare-MedicaidPRprior auth requiredNov 3, 2025Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification

Payer coverage policies that name 41830

41830 appears in 2 coverage policies from Aetna, Regence.

PayerPolicyRole in policyReviewedDocument
AetnaDental Services and Oral and Maxillofacial Surgery: Coverage Under Medical Plans (0082)covered if criteria are metMar 18, 2026payer document
RegenceAdministrative Guidelines to Determine Dental vs Medical Services (Allied Health 35)listed, no stanceJan 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in VA.

  • AZ: $204.42 (asc), effective Oct 1, 2026
  • CO: $290.70 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $229.38 (physician, facility), effective Jan 1, 2026
  • IL: $224.70 (practitioner), effective Jul 1, 2026
  • IN: $240.65 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $300.00 (asc, facility), effective Aug 1, 1982
  • KY: $364.70 (asc), effective Jan 1, 2026
  • LA: $365.14 (professional), effective Jul 1, 2025
  • MA: $276.70 (asc), effective May 1, 2026
  • MS: $258.51 (comprehensive, facility), effective Oct 1, 2025
  • ND: $360.72 (physician, facility), effective Aug 1, 2026
  • NE: $21.92 (physician, facility), effective Jul 1, 2026
  • NY: $136.25 (physician_surgery, facility), effective Jul 1, 2026
  • OK: $255.59 (physician, facility), effective Jul 1, 2026
  • TX: $276.02 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $255.50 (medical, facility), effective Jul 1, 2026
  • VT: $2574.33 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $177.34 (physician, facility), effective Jul 1, 2026
  • WY: $1466.22 (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.