Payer policies › CPT 5560555605 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 55605 1 of 1 payer prior-auth lists that name 55605 require prior authorization or set conditions: Humana.
Medicaid fee-for-service AZ: $541.83 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $224.49 (chp_plus, non-facility), effective Jul 1, 2026 FL: $374.85 (physician, non-facility), effective Jan 1, 2026 IL: $358.72 (practitioner), effective Apr 1, 2024 IN: $407.71 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $313.35 (default, Exempt Physician), effective Aug 1, 2024 KY: $387.55 (physician, facility), effective Jan 1, 2026 LA: $425.43 (professional), effective Jul 1, 2025 MA: $388.62 (physician_surgery), effective May 1, 2024 MS: $405.14 (comprehensive), effective Jul 1, 2026 ND: $517.43 (physician), effective Aug 1, 2026 NE: $681.72 (physician, non-facility), effective Jul 1, 2026 NY: $252.51 (physician_surgery, facility), effective Jul 1, 2026 OH: $376.98 (physician), effective Jan 1, 2024 OK: $427.58 (physician, non-facility), effective Jul 1, 2026 TX: $423.41 (physician, Physician, facility), effective Mar 1, 2026 VA: $417.53 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $284.55 (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.