Payer policies › CPT 5092050920 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 50920 1 of 1 payer prior-auth lists that name 50920 require prior authorization or set conditions: Humana.
Payer coverage policies that name 50920 50920 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: $905.84 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $720.51 (chp_plus, non-facility), effective Jul 1, 2026 FL: $618.25 (physician, non-facility), effective Jan 1, 2026 IL: $602.30 (practitioner), effective Apr 1, 2024 IN: $682.23 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $535.58 (default, Exempt Physician), effective Aug 1, 2024 KY: $667.32 (physician, facility), effective Jan 1, 2026 LA: $746.31 (professional), effective Feb 1, 2013 MA: $646.73 (physician_surgery), effective May 1, 2024 MS: $673.13 (comprehensive), effective Jul 1, 2026 ND: $849.36 (physician), effective Aug 1, 2026 NE: $1482.00 (physician, non-facility), effective Jul 1, 2026 NY: $444.24 (physician_surgery, facility), effective Jul 1, 2026 OH: $656.42 (physician), effective Jan 1, 2024 OK: $709.05 (physician, non-facility), effective Jul 1, 2026 TX: $93.65 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $688.66 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $466.28 (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.