50543 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 50543

1 of 1 payer prior-auth lists that name 50543 require prior authorization or set conditions: Humana.

PayerPlanStatePrior authConditionsSinceSource
HumanaHumana Puerto Rico MA and Dual Medicare-MedicaidPRprior auth requiredNov 3, 2025Puerto 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 50543

50543 appears in 3 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBupivacaine Liposome (Exparel) (0941)listed, no stance (range 50010-53899)Jul 30, 2026payer document
AetnaNerve Blocks (0863)listed, no stance (range 50543-50548)Jul 23, 2026payer document
AetnaUltrasound Guidance – Selected Indications (0952)covered if criteria are met (range 50543-50549)Apr 27, 2026payer document

Medicaid fee-for-service

  • AZ: $3457.91 (asc), effective Oct 1, 2026
  • CO: $1166.41 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $1462.99 (pediatric_surgery, pediatric surgeon), effective Jan 1, 2025
  • IL: $1017.04 (practitioner), effective Apr 1, 2024
  • IN: $1147.47 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $435.00 (asc, facility), effective Jan 1, 2003
  • KY: $1038.55 (physician, facility), effective Jan 1, 2026
  • LA: $1269.71 (professional), effective Feb 1, 2013
  • MA: $1087.24 (physician_surgery), effective May 1, 2024
  • MS: $1128.89 (comprehensive), effective Jul 1, 2026
  • ND: $1417.48 (physician), effective Aug 1, 2026
  • NE: $1452.36 (physician, non-facility), effective Jul 1, 2026
  • NY: $752.62 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $991.31 (physician), effective Jan 1, 2024
  • OK: $9572.22 (outpatient_hospital_apc), effective Jan 1, 2026
  • TX: $164.48 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026
  • VA: $1151.91 (medical), effective Jul 1, 2026
  • VT: $8253.65 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $777.39 (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.