45820 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 45820

Payer coverage policies that name 45820

45820 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaUrological Supplies (0533)listed, no stance (range 45000-45999)Jul 30, 2026payer document

Medicaid fee-for-service

  • AZ: $1305.07 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $598.60 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $942.71 (physician, non-facility), effective Jan 1, 2026
  • IL: $896.99 (practitioner), effective Apr 1, 2024
  • IN: $957.67 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $422.89 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $661.31 (physician, facility), effective Jan 1, 2026
  • LA: $1037.03 (professional), effective Jul 1, 2025
  • MA: $939.18 (physician_surgery), effective May 1, 2024
  • MS: $1002.59 (comprehensive), effective Jul 1, 2026
  • ND: $1244.38 (physician), effective Aug 1, 2026
  • NE: $1407.90 (physician, non-facility), effective Jul 1, 2026
  • NY: $550.60 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $660.29 (physician), effective Jan 1, 2024
  • OK: $1060.71 (physician, non-facility), effective Jul 1, 2026
  • TX: $142.79 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026
  • VA: $1050.06 (medical), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $702.29 (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.