Payer policies › CPT 4854848548 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 48548 Medicaid fee-for-service AZ: $1705.00 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $1136.62 (chp_plus, non-facility), effective Jul 1, 2026 FL: $1211.05 (physician, non-facility), effective Jan 1, 2026 IL: $1181.88 (practitioner), effective Apr 1, 2024 IN: $1249.94 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $573.72 (default, Exempt Physician), effective Aug 1, 2024 KY: $1144.24 (physician, facility), effective Jan 1, 2026 LA: $272.83 (professional), effective Jul 1, 2025 MA: $1223.49 (physician_surgery), effective May 1, 2024 MS: $1294.43 (comprehensive), effective Jul 1, 2026 ND: $1587.20 (physician), effective Aug 1, 2026 NE: $2223.00 (physician, non-facility), effective Jul 1, 2026 NY: $749.75 (physician_surgery, facility), effective Jul 1, 2026 OH: $955.96 (physician), effective Jan 1, 2024 OK: $1367.03 (physician, non-facility), effective Jul 1, 2026 TX: $192.61 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $1348.96 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $896.07 (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.