Payer policies › CPT 4810048100 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 48100 Payer coverage policies that name 48100 48100 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Ultrasound Guidance – Selected Indications (0952) covered if criteria are met Apr 27, 2026 payer document
Medicaid fee-for-service AZ: $910.38 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $523.78 (chp_plus, non-facility), effective Jul 1, 2026 FL: $656.44 (physician, non-facility), effective Jan 1, 2026 IL: $628.50 (practitioner), effective Apr 1, 2024 IN: $669.35 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $470.72 (default, Exempt Physician), effective Aug 1, 2024 KY: $431.13 (physician, facility), effective Jan 1, 2026 LA: $145.54 (professional), effective Jul 1, 2025 MA: $654.22 (physician_surgery), effective May 1, 2024 MS: $699.90 (comprehensive), effective Jul 1, 2026 ND: $869.64 (physician), effective Aug 1, 2026 NE: $1222.64 (physician, non-facility), effective Jul 1, 2026 NY: $397.07 (physician_surgery, facility), effective Jul 1, 2026 OH: $472.06 (physician), effective Jan 1, 2024 OK: $739.99 (physician, non-facility), effective Jul 1, 2026 TX: $99.43 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $731.19 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $489.41 (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.