Payer policies › CPT 4497044970 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 44970 Medicaid fee-for-service Prior authorization required or conditional in WV.
AZ: $1984.28 (asc), effective Oct 1, 2026 CO: $477.11 (chp_plus, non-facility), effective Jul 1, 2026 FL: $606.29 (pediatric_surgery, pediatric surgeon), effective Jan 1, 2025 IL: $424.25 (practitioner), effective Apr 1, 2024 IN: $456.16 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $500.00 (asc, facility), effective Jan 1, 2000 KY: $2958.68 (asc), effective Jan 1, 2026 LA: $491.68 (professional), effective Jul 1, 2025 MA: $446.43 (physician_surgery), effective May 1, 2024 MS: $4591.06 (comprehensive), effective Jul 1, 2026 ND: $597.03 (physician), effective Aug 1, 2026 NE: $1444.94 (physician, non-facility), effective Jul 1, 2026 NY: $267.83 (physician_surgery, facility), effective Jul 1, 2026 OH: $370.87 (physician), effective Jan 1, 2024 OK: $5444.03 (outpatient_hospital_apc), effective Jan 1, 2026 TX: $71.51 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $500.87 (medical), effective Jul 1, 2026 VT: $4694.12 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $336.34 (physician, facility), effective Jul 1, 2026 WY: $2673.55 (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.