56820 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 56820

Payer coverage policies that name 56820

56820 appears in 2 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaAcupuncture and Dry Needling (0135)listed, no stance (range 56405-58999)Mar 25, 2026payer document
AetnaUrological Supplies (0533)listed, no stance (range 56405-58999)Jul 30, 2026payer document

Medicaid fee-for-service

  • AZ: $38.57 (asc), effective Oct 1, 2026
  • CO: $98.37 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $58.71 (physician, facility), effective Jan 1, 2026
  • IL: $58.28 (practitioner), effective Apr 1, 2024
  • IN: $64.47 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $225.75 (asc, facility), effective Jan 1, 2003
  • KY: $68.81 (asc), effective Jan 1, 2026
  • LA: $100.22 (professional), effective Jul 1, 2025
  • MA: $51.84 (asc), effective May 1, 2026
  • MS: $52.53 (comprehensive, facility), effective Oct 1, 2025
  • ND: $68.06 (physician, facility), effective Aug 1, 2026
  • NE: $69.00 (physician, facility), effective Jul 1, 2026
  • NY: $39.30 (midwife, facility), effective Jul 1, 2026
  • OH: $60.45 (physician, facility), effective Jan 1, 2024
  • OK: $62.78 (asc), effective Jan 1, 2026
  • TX: $55.10 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $76.64 (medical, facility), effective Jul 1, 2026
  • VT: $156.98 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $43.76 (physician, facility), effective Jul 1, 2026
  • WY: $89.41 (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.