44005 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 44005

1 of 1 payer prior-auth lists that name 44005 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross and Blue Shield of TexasTexas PA exemption (gold card), outpatient, fully insuredTXprior auth requiredGold-card exemption availableJul 1, 2026BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range)

Payer coverage policies that name 44005

44005 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 44005-44799)Jul 1, 2026payer document

Medicaid fee-for-service

  • AZ: $1115.40 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $856.42 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $1099.62 (pediatric_surgery, pediatric surgeon), effective Jan 1, 2025
  • IL: $769.16 (practitioner), effective Apr 1, 2024
  • IN: $820.24 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $500.00 (asc, facility), effective Aug 1, 1982
  • KY: $631.99 (physician, facility), effective Jan 1, 2026
  • LA: $178.07 (professional), effective Jul 1, 2025
  • MA: $799.55 (physician_surgery), effective May 1, 2024
  • MS: $849.27 (comprehensive), effective Jul 1, 2026
  • ND: $1045.75 (physician), effective Aug 1, 2026
  • NE: $216.01 (physician, non-facility), effective Jul 1, 2026
  • NY: $494.16 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $603.02 (physician), effective Jan 1, 2000
  • OK: $896.94 (physician, non-facility), effective Jul 1, 2026
  • TX: $120.21 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026
  • VA: $883.97 (medical), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $588.78 (physician, facility), effective Jul 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.