47564 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 47564

Payer coverage policies that name 47564

47564 appears in 2 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaAnesthetic and Antiemetic Infusion Pumps (0607)listed, no stance (range 47562-47564)Sep 9, 2026payer document
AetnaObesity Surgery (0157)listed, no stance (range 47562-47620)Jul 21, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in WV.

  • AZ: $3457.91 (asc), effective Oct 1, 2026
  • CO: $881.27 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $825.55 (physician, non-facility), effective Jan 1, 2026
  • IL: $801.90 (practitioner), effective Jul 1, 2026
  • IN: $842.89 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $435.00 (asc, facility), effective Jan 1, 2000
  • KY: $4998.38 (asc), effective Jan 1, 2026
  • LA: $912.44 (professional), effective Jul 1, 2025
  • MA: $1864.96 (asc), effective May 1, 2026
  • MS: $3916.80 (comprehensive, facility), effective Oct 1, 2025
  • ND: $2946.55 (physician, facility), effective Aug 1, 2026
  • NE: $1183.00 (asc), effective Jul 1, 2024
  • NY: $397.38 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $673.32 (physician), effective Jan 1, 2024
  • OK: $4560.12 (asc), effective Jan 1, 2026
  • TX: $1888.85 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $919.56 (medical), effective Jul 1, 2026
  • VT: $8253.65 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $446.73 (asc), effective Jul 1, 2026
  • WY: $4700.90 (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.