49451 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 49451

Payer coverage policies that name 49451

49451 appears in 1 coverage policy from Aetna.

Medicaid fee-for-service

• AZ: $343.75 (asc), effective Oct 1, 2026
• CO: $77.27 (chp_plus, non-facility), effective Jul 1, 2026
• FL: $59.74 (physician, facility), effective Jan 1, 2026
• IN: $67.46 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
• KS: $87.15 (asc, facility), effective Jan 1, 2008
• KY: $485.98 (asc), effective Jan 1, 2026
• LA: $518.60 (professional), effective Feb 1, 2013
• MA: $337.55 (asc), effective May 1, 2026
• MS: $402.71 (comprehensive, facility), effective Oct 1, 2025
• ND: $286.48 (physician, facility), effective Aug 1, 2026
• NE: $413.00 (asc), effective Jul 1, 2024
• NY: $161.60 (physician_surgery, facility), effective Jul 1, 2026
• OH: $85.49 (physician, facility), effective Jan 1, 2024
• OK: $68.90 (physician, facility), effective Jul 1, 2026
• TX: $334.95 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
• VA: $65.97 (medical, facility), effective Jul 1, 2026
• VT: $704.24 (outpatient_hospital_opps), effective Feb 1, 2026
• WA: $308.28 (asc), effective Jul 1, 2026
• WY: $401.10 (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.