53446 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 53446

1 of 1 payer prior-auth lists that name 53446 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 53446

53446 appears in 3 coverage policies from Aetna, Anthem.

PayerPolicyRole in policyReviewedDocument
AetnaBupivacaine Liposome (Exparel) (0941)listed, no stance (range 50010-53899)Jul 30, 2026payer document
AetnaUrinary Incontinence (0223)covered if criteria are metJul 16, 2026payer document
AnthemTreatments for Urinary Incontinence (CG-SURG-134)covered if criteria are metMay 14, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in LA.

  • AZ: $1977.90 (asc), effective Oct 1, 2026
  • CO: $528.62 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $456.68 (physician, non-facility), effective Jan 1, 2026
  • IL: $494.90 (practitioner), effective Jul 30, 2019
  • IN: $499.07 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KY: $2664.56 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $1679.83 (asc), effective May 1, 2026
  • MS: $2017.28 (comprehensive, facility), effective Oct 1, 2025
  • ND: $1570.76 (physician, facility), effective Aug 1, 2026
  • NE: $637.00 (asc), effective Jul 1, 2024
  • NY: $327.22 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $507.15 (physician), effective Jan 1, 2002
  • OK: $2430.93 (asc), effective Jan 1, 2026
  • TX: $1689.43 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $508.68 (medical), effective Jul 1, 2026
  • VT: $4163.23 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $366.60 (asc), effective Jul 1, 2026
  • WY: $2371.18 (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.