41850 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 41850

1 of 1 payer prior-auth lists that name 41850 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 41850

41850 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

  • AZ: $396.13 (asc), effective Oct 1, 2026
  • CO: $22.45 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $17.72 (physician, non-facility), effective Jan 1, 2026
  • IL: $41.25 (practitioner), effective Jul 1, 2026
  • IN: $0.00 (professional, facility), effective Jan 1, 2010
  • KS: $11.25 (default, Exempt Physician), effective Jul 1, 1987
  • KY: $643.45 (asc), effective Jan 1, 2026
  • LA: $17.07 (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: $8.86 (physician, non-facility), effective Jul 1, 2026
  • OK: $0.00 (physician, non-facility), effective Jul 1, 2026
  • TX: $420.64 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $102.46 (medical), effective Jul 1, 2009
  • VT: $1204.74 (outpatient_hospital_opps), effective Feb 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.