Payer policies › CPT 5052550525 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 50525 1 of 1 payer prior-auth lists that name 50525 require prior authorization or set conditions: Humana.
Payer coverage policies that name 50525 50525 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Bupivacaine Liposome (Exparel) (0941) listed, no stance (range 50010-53899) Jul 30, 2026 payer document
Medicaid fee-for-service AZ: $1505.21 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $897.91 (chp_plus, non-facility), effective Jul 1, 2026 FL: $1072.33 (physician, non-facility), effective Jan 1, 2026 IL: $1039.82 (practitioner), effective Apr 1, 2024 IN: $1103.50 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $450.00 (asc, facility), effective Aug 1, 1982 KY: $990.76 (physician, facility), effective Jan 1, 2026 LA: $1200.86 (professional), effective Jul 1, 2025 MA: $1079.02 (physician_surgery), effective May 1, 2024 MS: $1144.47 (comprehensive), effective Jul 1, 2026 ND: $1408.09 (physician), effective Aug 1, 2026 NE: $1778.40 (physician, non-facility), effective Jul 1, 2026 NY: $666.03 (physician_surgery, facility), effective Jul 1, 2026 OH: $938.67 (physician), effective Jan 1, 2000 OK: $1209.33 (physician, non-facility), effective Jul 1, 2026 TX: $170.55 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $1194.45 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $794.98 (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.