Payer policies › CPT 5565055650 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 55650 1 of 1 payer prior-auth lists that name 55650 require prior authorization or set conditions: Humana.
Medicaid fee-for-service AZ: $739.53 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $588.71 (chp_plus, non-facility), effective Jul 1, 2026 FL: $506.81 (physician, non-facility), effective Jan 1, 2026 IL: $702.00 (practitioner), effective Apr 1, 2024 IN: $556.69 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $439.45 (default, Exempt Physician), effective Aug 1, 2024 KY: $542.53 (physician, facility), effective Jan 1, 2026 LA: $605.19 (professional), effective Feb 1, 2013 MA: $528.95 (physician_surgery), effective May 1, 2024 MS: $550.66 (comprehensive), effective Jul 1, 2026 ND: $697.29 (physician), effective Aug 1, 2026 NE: $1704.30 (physician, non-facility), effective Jul 1, 2026 NY: $363.64 (physician_surgery, facility), effective Jul 1, 2026 OH: $526.32 (physician), effective Jan 1, 2024 OK: $580.35 (physician, non-facility), effective Jul 1, 2026 TX: $85.07 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), facility), effective Mar 1, 2026 VA: $564.53 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $382.77 (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.