Payer policies › CPT 4815048150 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 48150 Payer coverage policies that name 48150 48150 appears in 5 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Indocyanine Green Angiography (0111) listed, no stance (range 48150-48154) Mar 18, 2026 payer document Aetna Nerve Blocks (0863) listed, no stance (range 48150-48154) Jul 23, 2026 payer document Aetna Pancreaticoduodenectomy (Whipple Resection) (0365) covered if criteria are met May 22, 2026 payer document Aetna Procalcitonin (PCT) (0771) listed, no stance (range 48150-48154) Nov 13, 2025 payer document Aetna Somatostatin Analogs (0693) listed, no stance Jul 15, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in IN.
AZ: $3171.85 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $2438.63 (chp_plus, non-facility), effective Jul 1, 2026 FL: $2232.99 (physician, non-facility), effective Jan 1, 2026 IL: $2197.15 (practitioner), effective Apr 1, 2024 IN: $2328.40 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $1153.31 (default, Exempt Physician), effective Aug 1, 2024 KY: $1901.07 (physician, facility), effective Jan 1, 2026 LA: $507.80 (professional), effective Jul 1, 2025 MA: $2276.21 (physician_surgery), effective May 1, 2024 MS: $2392.04 (comprehensive), effective Jul 1, 2026 ND: $2939.73 (physician), effective Aug 1, 2026 NE: $569.63 (physician, non-facility), effective Jul 1, 2026 NY: $1412.28 (physician_surgery, facility), effective Jul 1, 2026 OH: $1901.13 (physician), effective Jan 1, 2024 OK: $2526.15 (physician, non-facility), effective Jul 1, 2026 TX: $355.15 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $2487.27 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $1654.35 (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.