Payer policies › CPT 4815548155 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 48155 Medicaid fee-for-service Prior authorization required or conditional in IN.
AZ: $1857.02 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $1436.29 (chp_plus, non-facility), effective Jul 1, 2026 FL: $1331.07 (physician, non-facility), effective Jan 1, 2026 IL: $1438.70 (practitioner), effective Jul 1, 2026 IN: $1364.22 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $986.01 (default, Exempt Physician), effective Aug 1, 2024 KY: $1220.83 (physician, facility), effective Jan 1, 2026 LA: $1479.39 (professional), effective Jul 1, 2025 MA: $1342.69 (physician_surgery), effective May 1, 2024 MS: $1419.44 (comprehensive), effective Jul 1, 2026 ND: $1761.43 (physician), effective Aug 1, 2026 NE: $390.61 (physician, non-facility), effective Jul 1, 2026 NY: $809.26 (physician_surgery, facility), effective Jul 1, 2026 OH: $1218.99 (physician), effective Jan 1, 2024 OK: $1500.61 (physician, non-facility), effective Jul 1, 2026 TX: $201.62 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $1482.64 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $991.81 (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.