Payer policies › CPT 5054150541 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 50541 12 of 12 payer prior-auth lists that name 50541 require prior authorization or set conditions: CarePlus Health Plans, Humana.
Payer Plan State Prior auth Conditions Since Source CarePlus Health Plans CarePlus Health Plans FL prior auth required Jan 1, 2027 Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List Humana Humana D-SNP (FL) FL prior auth required Jan 1, 2027 1 *New prior authorization requirement 787403FL0725 FLHMQSREN Humana Dual Fully Integrated Florida Prior Authorization and Notification List Humana Humana D-SNP (IL) IL prior auth required Jan 1, 2027 Humana Dual Fully Integrated Illinois Prior Authorization and Notification List Humana Humana D-SNP (IN) IN prior auth required Jan 1, 2027 *New prior authorization requirement 814403IN0825 H4939_INHN6Z6EN_C Humana PathWays Dual Care (HMO-POS D-SNP) Indiana Prior Authorization and Notification List Humana Humana D-SNP (MI) MI prior auth required Jan 1, 2027 1 Humana Dual Highly Integrated Michigan Prior Authorization and Notification List Humana Humana D-SNP (SC) SC prior auth required Jan 1, 2027 Humana Dual Highly Integrated South Carolina Prior Authorization and Notification List Humana Humana D-SNP (VA) VA prior auth required Jan 1, 2027 Virginia Prior Authorization and Notification List Humana Humana Healthy Horizons IL prior auth required Jan 1, 2027 Humana Healthy Horizons in Illinois Prior Authorization and Notification List To view -specific medical coverage policies, please visit Humana Healthy Horizons in Illinois Clinical coverage policies . Humana Humana Healthy Horizons SC prior auth required Jan 1, 2027 Humana Healthy Horizons in South Carolina Prior authorization and Notification List The following list describes services and medications that are commonly reviewed and may require additional clinical Humana Humana MA and D-SNP All prior auth required Jan 1, 2027 Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List Humana Humana Puerto Rico MA and Dual Medicare-Medicaid PR prior auth required Nov 3, 2025 Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification Humana Humana Puerto Rico MA and Dual Medicare-Medicaid PR prior auth required Nov 3, 2025 Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification
Payer coverage policies that name 50541 50541 appears in 2 coverage policies 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 Aetna Ultrasound Guidance – Selected Indications (0952) covered if criteria are met Apr 27, 2026 payer document
Medicaid fee-for-service AZ: $3457.91 (asc), effective Oct 1, 2026 CO: $719.71 (chp_plus, non-facility), effective Jul 1, 2026 FL: $638.52 (physician, non-facility), effective Jan 1, 2026 IL: $718.70 (practitioner), effective Jul 1, 2026 IN: $707.28 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $435.00 (asc, facility), effective Jan 1, 2000 KY: $4998.38 (asc), effective Jan 1, 2026 LA: $784.33 (professional), effective Feb 1, 2013 MA: $670.61 (physician_surgery), effective May 1, 2024 MS: $697.00 (comprehensive), effective Jul 1, 2026 ND: $874.90 (physician), effective Aug 1, 2026 NE: $346.22 (physician, non-facility), effective Jul 1, 2026 NY: $466.46 (physician_surgery, facility), effective Jul 1, 2026 OH: $665.47 (physician), effective Jan 1, 2024 OK: $9572.22 (outpatient_hospital_apc), effective Jan 1, 2026 TX: $101.55 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $711.23 (medical), effective Jul 1, 2026 VT: $8253.65 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $480.04 (physician, facility), effective Jul 1, 2026 WY: $4700.90 (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.