46320 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 46320

Medicaid fee-for-service

  • AZ: $93.49 (asc), effective Oct 1, 2026
  • CO: $131.35 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $84.17 (physician, facility), effective Jan 1, 2026
  • IL: $78.13 (practitioner), effective Apr 1, 2024
  • IN: $87.35 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $250.00 (asc, facility), effective Aug 1, 1982
  • KY: $166.78 (asc), effective Jan 1, 2026
  • LA: $233.58 (asc), effective Jul 1, 2012
  • MA: $114.42 (asc), effective May 1, 2026
  • MS: $114.90 (comprehensive, facility), effective Oct 1, 2025
  • ND: $164.97 (physician, facility), effective Aug 1, 2026
  • NE: $76.22 (physician, facility), effective Jul 1, 2026
  • NY: $49.11 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $74.39 (physician, facility), effective Jan 1, 2024
  • OK: $152.16 (asc), effective Jan 1, 2026
  • TX: $125.69 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $93.75 (medical, facility), effective Jul 1, 2026
  • VT: $929.15 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $64.21 (physician, facility), effective Jul 1, 2026
  • WY: $529.20 (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.