49596 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 49596

Payer coverage policies that name 49596

49596 appears in 3 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaAbdominoplasty, Suction Lipectomy, and Ventral Hernia Repair (0211)covered if criteria are metAug 18, 2026payer document
AetnaCosmetic Surgery and Procedures (0031)
Thermal therapy (e.g., radiofrequency (ThermiVa and Viveve procedures) and laser), Laviv (azficel-T)
not coveredJun 25, 2026payer document
AetnaNerve Blocks (0863)listed, no stance (range 49591-49596)Jul 23, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in WV.

  • AZ: $1046.71 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $825.43 (health_first_colorado), effective Jul 1, 2026
  • FL: $236.92 (physician, non-facility), effective Jan 1, 2026
  • IL: $726.23 (practitioner), effective Apr 1, 2024
  • IN: $767.46 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $484.88 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $859.97 (physician, facility), effective Jan 1, 2026
  • LA: $921.51 (professional), effective Jan 1, 2023
  • MA: $744.02 (physician_surgery), effective May 1, 2024
  • MS: $784.00 (comprehensive), effective Jul 1, 2026
  • ND: $947.37 (physician), effective Aug 1, 2026
  • NE: $1662.00 (asc), effective Jul 1, 2024
  • NY: $572.79 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $796.76 (physician), effective Jan 1, 2023
  • OK: $826.82 (physician, non-facility), effective Jul 1, 2026
  • TX: $787.00 (physician, Physician, facility), effective Sep 1, 2026
  • VA: $811.34 (medical, facility), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $534.32 (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.