Payer policies › CPT 4323243232 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 43232 Payer coverage policies that name 43232 43232 appears in 4 coverage policies from Aetna, Centene, Regence.
Payer Policy Role in policy Reviewed Document Aetna Endoscopic Ultrasonography (0446) covered if criteria are met Jul 22, 2026 payer document Aetna Upper Gastrointestinal Endoscopy and Gastrointestinal Biopsy (0738) covered if criteria are met Oct 29, 2025 payer document Aetna Upper Gastrointestinal Endoscopy and Gastrointestinal Biopsy (0738) covered if criteria are met (range 43200-43232) Oct 29, 2025 payer document Centene Anesthesiology Services for Gastrointestinal Endoscopy (CP.MP.161) covered if criteria are met May 1, 2019 payer document Regence Surgical Site of Care – Hospital Outpatient (Utilization Management 19) listed, no stance May 1, 2026 payer document
Medicaid fee-for-service AZ: $617.94 (asc), effective Oct 1, 2026 CO: $159.53 (chp_plus, non-facility), effective Jul 1, 2026 FL: $137.94 (physician, facility), effective Jan 1, 2026 IL: $183.70 (practitioner), effective Jul 1, 2026 IN: $151.56 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $225.00 (asc, facility), effective Jan 1, 2001 KY: $873.00 (asc), effective Jan 1, 2026 LA: $182.30 (asc), effective Jul 1, 2012 MA: $563.60 (asc), effective May 1, 2026 MS: $691.32 (comprehensive, facility), effective Oct 1, 2025 ND: $514.64 (physician, facility), effective Aug 1, 2026 NE: $552.00 (asc), effective Jul 1, 2024 NY: $126.78 (physician_surgery, facility), effective Jul 1, 2026 OH: $200.57 (physician), effective Jan 1, 2001 OK: $796.46 (asc), effective Jan 1, 2026 TX: $564.97 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023 VA: $153.65 (medical, facility), effective Jul 1, 2026 VT: $1489.96 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $308.28 (asc), effective Jul 1, 2026 WY: $848.61 (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.