50396 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 50396

Payer coverage policies that name 50396

50396 appears in 2 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBupivacaine Liposome (Exparel) (0941)listed, no stance (range 50010-53899)Jul 30, 2026payer document
AetnaUltrasound Guidance – Selected Indications (0952)covered if criteria are met (range 50390-50431)Apr 27, 2026payer document

Medicaid fee-for-service

  • AZ: $211.61 (asc), effective Oct 1, 2026
  • CO: $18.69 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $79.05 (physician, non-facility), effective Jan 1, 2026
  • IL: $77.54 (practitioner), effective Apr 1, 2024
  • IN: $89.52 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $78.99 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $303.22 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $239.03 (asc), effective May 1, 2026
  • MS: $252.74 (comprehensive, facility), effective Oct 1, 2025
  • ND: $178.75 (physician, facility), effective Aug 1, 2026
  • NE: $413.00 (asc), effective Jul 1, 2024
  • NY: $60.72 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $69.02 (physician), effective Jan 1, 2000
  • OK: $276.64 (asc), effective Jan 1, 2026
  • TX: $238.15 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $86.81 (medical), effective Jul 1, 2026
  • VT: $541.42 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $308.37 (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.