42400 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 42400

Payer coverage policies that name 42400

42400 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaParkinson's Disease (0307)not coveredFeb 24, 2026payer document

Medicaid fee-for-service

  • AZ: $36.74 (asc), effective Oct 1, 2026
  • CO: $58.02 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $37.15 (physician, facility), effective Jan 1, 2026
  • IL: $50.66 (practitioner), effective Apr 1, 2024
  • IN: $41.14 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $50.00 (asc, facility), effective Aug 1, 1982
  • KY: $65.54 (asc), effective Jan 1, 2026
  • LA: $77.12 (professional), effective Feb 1, 2013
  • MA: $63.81 (asc), effective May 1, 2026
  • MS: $50.98 (comprehensive, facility), effective Oct 1, 2025
  • ND: $64.82 (physician, facility), effective Aug 1, 2026
  • NE: $40.75 (physician, facility), effective Jul 1, 2026
  • NY: $28.68 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $47.88 (physician, facility), effective Jan 1, 2024
  • OK: $42.19 (physician, facility), effective Jul 1, 2026
  • TX: $57.58 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $41.38 (medical, facility), effective Jul 1, 2026
  • VT: $549.84 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $28.47 (physician, facility), effective Jul 1, 2026
  • WY: $313.16 (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.