Payer policies › CPT 4580045800 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 45800 Payer coverage policies that name 45800 45800 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: $1301.93 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $598.60 (chp_plus, non-facility), effective Jul 1, 2026 FL: $940.63 (physician, non-facility), effective Jan 1, 2026 IL: $894.57 (practitioner), effective Apr 1, 2024 IN: $955.38 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $658.84 (default, Exempt Physician), effective Aug 1, 2024 KY: $672.75 (physician, facility), effective Jan 1, 2026 LA: $1034.28 (professional), effective Jul 1, 2025 MA: $936.71 (physician_surgery), effective May 1, 2024 MS: $1000.09 (comprehensive), effective Jul 1, 2026 ND: $1241.75 (physician), effective Aug 1, 2026 NE: $1407.90 (physician, non-facility), effective Jul 1, 2026 NY: $553.47 (physician_surgery, facility), effective Jul 1, 2026 OH: $666.31 (physician), effective Jan 1, 2024 OK: $1058.31 (physician, non-facility), effective Jul 1, 2026 TX: $149.60 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $1047.74 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $700.76 (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.