49521 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 49521

Payer coverage policies that name 49521

49521 appears in 3 coverage policies from Aetna, Regence.

PayerPolicyRole in policyReviewedDocument
AetnaAnesthetic and Antiemetic Infusion Pumps (0607)listed, no stance (range 49491-49525)Sep 9, 2026payer document
AetnaNerve Blocks (0863)listed, no stance (range 49491-49525)Jul 23, 2026payer document
RegenceSurgical Site of Care – Hospital Outpatient (Utilization Management 19)listed, no stanceMay 1, 2026payer document

Medicaid fee-for-service

  • AZ: $2423.12 (asc), effective Oct 1, 2026
  • CO: $567.06 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $720.61 (pediatric_surgery, pediatric surgeon), effective Jan 1, 2025
  • IL: $506.06 (practitioner), effective Apr 1, 2024
  • IN: $542.77 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $465.00 (asc, facility), effective Jan 1, 1994
  • KY: $3284.86 (asc), effective Jan 1, 2026
  • LA: $265.13 (asc), effective Jul 1, 2012
  • MA: $1170.63 (asc), effective May 1, 2026
  • MS: $2536.92 (comprehensive, facility), effective Oct 1, 2025
  • ND: $1936.43 (physician, facility), effective Aug 1, 2026
  • NE: $785.00 (asc), effective Jul 1, 2024
  • NY: $348.12 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $440.54 (physician), effective Jan 1, 2024
  • OK: $2996.85 (asc), effective Jan 1, 2026
  • TX: $1151.54 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $593.46 (medical), effective Jul 1, 2026
  • VT: $5026.67 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $366.60 (asc), effective Jul 1, 2026
  • WY: $2862.96 (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.