Payer policies › CPT 5413554135 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 54135 1 of 1 payer prior-auth lists that name 54135 require prior authorization or set conditions: Humana.
Medicaid fee-for-service AZ: $1543.91 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $1159.82 (chp_plus, non-facility), effective Jul 1, 2026 FL: $1045.58 (physician, non-facility), effective Jan 1, 2026 IL: $1031.13 (practitioner), effective Apr 1, 2024 IN: $1163.23 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $942.11 (default, Exempt Physician), effective Aug 1, 2024 KY: $1252.25 (physician, facility), effective Jan 1, 2026 LA: $1298.43 (professional), effective Feb 1, 2013 MA: $1100.62 (physician_surgery), effective May 1, 2024 MS: $1143.57 (comprehensive), effective Jul 1, 2026 ND: $1432.50 (physician), effective Aug 1, 2026 NE: $503.06 (physician, non-facility), effective Jul 1, 2026 NY: $767.78 (physician_surgery, facility), effective Jul 1, 2026 OH: $1150.33 (physician), effective Jan 1, 2000 OK: $1203.15 (physician, non-facility), effective Jul 1, 2026 TX: $186.41 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2026 VA: $1164.64 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $785.04 (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.