45320 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 45320

Payer coverage policies that name 45320

45320 appears in 2 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaRisankizumab-rzaa (Skyrizi) (1009)listed, no stance (range 45300-45393)Jul 1, 2026payer document
AetnaUrological Supplies (0533)listed, no stance (range 45000-45999)Jul 30, 2026payer document

Medicaid fee-for-service

  • AZ: $913.45 (asc), effective Oct 1, 2026
  • CO: $65.48 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $77.41 (physician, facility), effective Jan 1, 2026
  • IL: $105.06 (practitioner), effective Apr 1, 2024
  • IN: $79.19 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $225.00 (asc, facility), effective Aug 1, 1982
  • KY: $1398.34 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $935.17 (asc), effective May 1, 2026
  • MS: $1118.38 (comprehensive, facility), effective Oct 1, 2025
  • ND: $824.33 (physician, facility), effective Aug 1, 2026
  • NE: $552.00 (asc), effective Jul 1, 2024
  • NY: $55.55 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $85.12 (physician, facility), effective Jan 1, 2016
  • OK: $1275.74 (asc), effective Jan 1, 2026
  • TX: $939.93 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $86.23 (medical, facility), effective Jul 1, 2026
  • VT: $2155.19 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), effective Jul 1, 2026
  • WY: $1227.50 (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.