50725 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 50725

1 of 1 payer prior-auth lists that name 50725 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 50725

50725 appears in 2 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 stanceJul 23, 2026payer document

Medicaid fee-for-service

  • AZ: $1128.30 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $896.16 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $767.10 (physician, non-facility), effective Jan 1, 2026
  • IL: $958.60 (practitioner), effective Jul 1, 2026
  • IN: $849.91 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $441.14 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $868.09 (physician, facility), effective Jan 1, 2026
  • LA: $927.79 (professional), effective Feb 1, 2013
  • MA: $805.26 (physician_surgery), effective May 1, 2024
  • MS: $837.34 (comprehensive), effective Jul 1, 2026
  • ND: $1052.50 (physician), effective Aug 1, 2026
  • NE: $1852.50 (physician, non-facility), effective Jul 1, 2026
  • NY: $547.79 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $855.27 (physician), effective Jan 1, 2024
  • OK: $881.43 (physician, non-facility), effective Jul 1, 2026
  • TX: $116.20 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026
  • VA: $854.46 (medical), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $577.12 (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.