49436 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 49436

Medicaid fee-for-service

  • AZ: $617.94 (asc), effective Oct 1, 2026
  • CO: $437.50 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $138.20 (physician, facility), effective Jan 1, 2026
  • IL: $130.17 (practitioner), effective Apr 1, 2024
  • IN: $140.76 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $202.09 (asc, facility), effective Jan 1, 2007
  • KY: $873.00 (asc), effective Jan 1, 2026
  • LA: $411.96 (professional), effective Jul 1, 2025
  • MA: $563.60 (asc), effective May 1, 2026
  • MS: $691.32 (comprehensive, facility), effective Oct 1, 2025
  • ND: $514.64 (physician, facility), effective Aug 1, 2026
  • NE: $370.50 (physician, non-facility), effective Jul 1, 2026
  • NY: $85.91 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $106.17 (physician), effective Jan 1, 2024
  • OK: $154.97 (physician, facility), effective Jul 1, 2026
  • TX: $564.97 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $153.94 (medical, facility), effective Jul 1, 2026
  • VT: $1489.96 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $848.61 (outpatient_hospital_apc, Ambulatory Surgical Centers), 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.