Payer policies › CPT 4712047120 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 47120 1 of 1 payer prior-auth lists that name 47120 require prior authorization or set conditions: Blue Cross and Blue Shield of Illinois.
Payer Plan State Prior auth Conditions Since Source Blue Cross and Blue Shield of Illinois Blue Cross Community MMAI (Medicare-Medicaid Alignment Initiative) IL prior auth required Jan 1, 2025 Procedure Code List, Effective 1/1/2025
Payer coverage policies that name 47120 47120 appears in 2 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Liver Transplantation (0596) listed, no stance (range 47120-47130) Sep 8, 2026 payer document Aetna Liver and Other Neoplasms - Treatment Approaches (0268) listed, no stance Sep 18, 2026 payer document
Recent prior-auth changes Apr 1, 2026: PA removed, Blue Cross and Blue Shield of Illinois Apr 1, 2026: PA removed, Blue Cross and Blue Shield of Illinois Medicaid fee-for-service Prior authorization required or conditional in IN.
AZ: $2380.02 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $1832.02 (chp_plus, non-facility), effective Jul 1, 2026 FL: $2335.00 (pediatric_surgery, pediatric surgeon), effective Jan 1, 2025 IL: $1644.03 (practitioner), effective Apr 1, 2024 IN: $1748.48 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $1381.56 (default, Exempt Physician), effective Aug 1, 2024 KY: $968.70 (physician, facility), effective Jan 1, 2026 LA: $380.33 (professional), effective Jul 1, 2025 MA: $1710.86 (physician_surgery), effective May 1, 2024 MS: $1802.72 (comprehensive), effective Jul 1, 2026 ND: $2223.29 (physician), effective Aug 1, 2026 NE: $1546.83 (physician, non-facility), effective Jul 1, 2026 NY: $1057.38 (physician_surgery, facility), effective Jul 1, 2026 OH: $1272.12 (physician), effective Jan 1, 2024 OK: $1904.32 (physician, non-facility), effective Jul 1, 2026 TX: $268.01 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $1877.03 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $1251.13 (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.