Payer policies › CPT 6100161001 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 61001 Payer coverage policies that name 61001 61001 appears in 5 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Grid Monitoring and Intraoperative Electroencephalography (0289) listed, no stance (range 61000-61253) Apr 17, 2026 payer document Aetna Intraoperative Neurophysiological Monitoring (0697) covered if criteria are met (range 61000-61070) Jun 19, 2026 payer document Aetna Intravenous Iron Therapy (0575) listed, no stance (range 61000-64999) Jul 1, 2026 payer document Aetna Respiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479) listed, no stance (range 61000-64999) Jul 9, 2026 payer document Aetna Thermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703) listed, no stance (range 61000-64999) Nov 24, 2025 payer document
Medicaid fee-for-service AZ: $313.95 (asc), effective Oct 1, 2026 CO: $83.89 (chp_plus, non-facility), effective Jul 1, 2026 FL: $82.35 (physician, non-facility), effective Jan 1, 2026 IN: $79.52 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $250.00 (asc, facility), effective Aug 1, 1982 KY: $378.22 (asc), effective Jan 1, 2026 LA: $88.27 (professional), effective Jul 1, 2025 MA: $268.46 (asc), effective May 1, 2026 MS: $297.40 (comprehensive, facility), effective Oct 1, 2025 ND: $222.96 (physician, facility), effective Aug 1, 2026 NE: $103.74 (physician, non-facility), effective Jul 1, 2026 NY: $50.74 (physician_surgery, facility), effective Jul 1, 2026 OH: $76.35 (physician), effective Jan 1, 2024 OK: $91.20 (physician, non-facility), effective Jul 1, 2026 TX: $262.86 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023 VA: $91.72 (medical), effective Jul 1, 2026 VT: $548.09 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $60.96 (physician, facility), effective Jul 1, 2026 WY: $312.17 (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.