Payer policies › CPT 5716057160 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 57160 Payer coverage policies that name 57160 57160 appears in 3 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Acupuncture and Dry Needling (0135) listed, no stance (range 56405-58999) Mar 25, 2026 payer document Aetna Urinary Incontinence (0223) covered if criteria are met Jul 16, 2026 payer document Aetna Urological Supplies (0533) listed, no stance (range 56405-58999) Jul 30, 2026 payer document
Medicaid fee-for-service AZ: $20.02 (asc), effective Oct 1, 2026 CO: $53.77 (chp_plus, non-facility), effective Jul 1, 2026 FL: $31.71 (physician, facility), effective Jan 1, 2026 IL: $31.94 (practitioner), effective Apr 1, 2024 IN: $35.09 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $49.00 (default, Exempt Physician), effective Aug 1, 2024 KY: $35.72 (asc), effective Jan 1, 2026 LA: $59.24 (professional), effective Jul 1, 2025 MA: $28.83 (asc), effective May 1, 2026 MS: $30.79 (comprehensive, facility), effective Oct 1, 2025 ND: $35.33 (physician, facility), effective Aug 1, 2026 NE: $37.52 (physician, facility), effective Jul 1, 2026 NY: $22.15 (midwife, facility), effective Jul 1, 2026 OH: $31.66 (physician, facility), effective Jan 1, 2024 OK: $36.16 (physician, facility), effective Jul 1, 2026 TX: $33.50 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023 VA: $41.03 (medical, facility), effective Jul 1, 2026 VT: $156.98 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $23.31 (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.