57320 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 57320

1 of 1 payer prior-auth lists that name 57320 require prior authorization or set conditions: Humana.

PayerPlanStatePrior authConditionsSinceSource
HumanaHumana Puerto Rico MA and Dual Medicare-MedicaidPRprior auth requiredNov 3, 2025Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification

Payer coverage policies that name 57320

57320 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: $1698.98 (asc), effective Oct 1, 2026
  • CO: $462.90 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $390.88 (physician, non-facility), effective Jan 1, 2026
  • IL: $597.90 (practitioner), effective Jul 1, 2026
  • IN: $432.58 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $320.77 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $2240.80 (asc), effective Jan 1, 2026
  • LA: $92.04 (professional), effective Jul 1, 2025
  • MA: $1543.91 (asc), effective May 1, 2026
  • MS: $1780.46 (comprehensive, facility), effective Oct 1, 2025
  • ND: $1320.95 (physician, facility), effective Aug 1, 2026
  • NE: $288.51 (physician, non-facility), effective Jul 1, 2026
  • NY: $263.65 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $441.43 (physician), effective Jan 1, 2000
  • OK: $2044.33 (asc), effective Jan 1, 2026
  • TX: $1526.99 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $509.36 (medical), effective Jul 1, 2026
  • VT: $3884.21 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), effective Jul 1, 2026
  • WY: $2212.27 (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.