Payer policies › CPT 4932649326 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 49326 Payer coverage policies that name 49326 49326 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Obesity Surgery (0157) listed, no stance Jul 21, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in WV.
AZ: $2632.61 (outpatient_hospital), effective Oct 1, 2013 CO: $145.43 (chp_plus, non-facility), effective Jul 1, 2026 FL: $131.70 (physician, non-facility), effective Jan 1, 2026 IL: $190.69 (practitioner), effective Apr 1, 2024 IN: $139.26 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $382.33 (asc, facility), effective Jan 1, 2007 KY: $0.00 (asc), effective Jan 1, 2026 LA: $153.67 (professional), effective Jul 1, 2025 MA: $0.00 (asc), effective May 1, 2026 MS: $142.17 (comprehensive), effective Jul 1, 2026 ND: $170.47 (physician), effective Aug 1, 2026 NE: $73.98 (physician, non-facility), effective Jul 1, 2026 NY: $87.45 (physician_surgery, facility), effective Jul 1, 2026 OH: $113.06 (physician), effective Jan 1, 2024 OK: $149.74 (physician, non-facility), effective Jul 1, 2026 TX: $19.95 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $146.70 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $96.12 (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.