Payer policies › CPT 6105061050 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 61050 Payer coverage policies that name 61050 61050 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: $158.91 (asc), effective Oct 1, 2026 CO: $65.63 (chp_plus, non-facility), effective Jul 1, 2026 FL: $55.38 (physician, non-facility), effective Jan 1, 2026 IL: $77.12 (practitioner), effective Apr 1, 2024 IN: $62.53 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $300.00 (asc, facility), effective Aug 1, 1982 KY: $164.48 (asc), effective Jan 1, 2026 LA: $182.30 (asc), effective Jul 1, 2012 MA: $112.43 (asc), effective May 1, 2026 MS: $126.78 (comprehensive, facility), effective Oct 1, 2025 ND: $96.96 (physician, facility), effective Aug 1, 2026 NE: $552.00 (asc), effective Jul 1, 2024 NY: $53.09 (physician_surgery, facility), effective Jul 1, 2026 OH: $77.67 (physician), effective Jan 1, 2004 OK: $150.06 (asc), effective Jan 1, 2026 TX: $108.15 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023 VA: $59.90 (medical), effective Jul 1, 2026 VT: $238.34 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $308.28 (asc), effective Jul 1, 2026 WY: $135.74 (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.