Payer policies › CPT 4742547425 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 47425 2 of 2 payer prior-auth lists that name 47425 require prior authorization or set conditions: Blue Cross and Blue Shield of Illinois.
Recent prior-auth changes Jul 1, 2026: PA removed, HealthSpring Jul 1, 2026: conditions changed, Blue Cross and Blue Shield of Illinois Medicaid fee-for-service AZ: $1395.38 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $860.51 (chp_plus, non-facility), effective Jul 1, 2026 FL: $999.08 (physician, non-facility), effective Jan 1, 2026 IL: $964.18 (practitioner), effective Apr 1, 2024 IN: $1023.63 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $473.34 (default, Exempt Physician), effective Aug 1, 2024 KY: $807.61 (physician, facility), effective Jan 1, 2026 LA: $1114.04 (professional), effective Jul 1, 2025 MA: $1005.31 (physician_surgery), effective May 1, 2024 MS: $1064.97 (comprehensive), effective Jul 1, 2026 ND: $1314.22 (physician), effective Aug 1, 2026 NE: $383.20 (physician, non-facility), effective Jul 1, 2026 NY: $611.67 (physician_surgery, facility), effective Jul 1, 2026 OH: $813.10 (physician), effective Jan 1, 2024 OK: $1125.75 (physician, non-facility), effective Jul 1, 2026 TX: $158.89 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $1112.85 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $741.85 (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.