Payer policies › CPT 4554045540 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 45540 Payer coverage policies that name 45540 45540 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Urological Supplies (0533) listed, no stance (range 45000-45999) Jul 30, 2026 payer document
Medicaid fee-for-service AZ: $1073.55 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $830.52 (chp_plus, non-facility), effective Jul 1, 2026 FL: $757.75 (physician, non-facility), effective Jan 1, 2026 IL: $723.72 (practitioner), effective Apr 1, 2024 IN: $801.20 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $624.28 (default, Exempt Physician), effective Aug 1, 2024 KY: $667.83 (physician, facility), effective Jan 1, 2026 LA: $850.56 (professional), effective Jul 1, 2025 MA: $775.56 (physician_surgery), effective May 1, 2024 MS: $816.94 (comprehensive), effective Jul 1, 2026 ND: $1024.34 (physician), effective Aug 1, 2026 NE: $258.92 (physician, non-facility), effective Jul 1, 2026 NY: $475.42 (physician_surgery, facility), effective Jul 1, 2026 OH: $649.19 (physician), effective Jan 1, 2024 OK: $862.23 (physician, non-facility), effective Jul 1, 2026 TX: $120.52 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $844.04 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $568.52 (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.