61534 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 61534

Payer coverage policies that name 61534

61534 appears in 11 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaEpilepsy Surgery (0394)covered if criteria are metJun 23, 2026payer document
AetnaGrid Monitoring and Intraoperative Electroencephalography (0289)listed, no stance (range 61304-61576)Apr 17, 2026payer document
AetnaInpatient Admission Prior to Surgery (Preop Days) (0255)listed, no stance (range 61304-61576)May 13, 2026payer document
AetnaIntraoperative Neurophysiological Monitoring (0697)covered if criteria are met (range 61304-61576)Jun 19, 2026payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 61000-64999)Jul 1, 2026payer document
AetnaNerve Blocks (0863)listed, no stance (range 61304-61576)Jul 23, 2026payer document
AetnaPositron Emission Tomography (PET) (0071)listed, no stanceSep 14, 2026payer document
AetnaRespiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479)listed, no stance (range 61000-64999)Jul 9, 2026payer document
AetnaSafety Items (0623)listed, no stance (range 61304-61619)Sep 23, 2026payer document
AetnaThermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703)listed, no stance (range 61000-64999)Nov 24, 2025payer document
AetnaVagus Nerve Stimulation (0191)listed, no stanceMar 31, 2026payer document

Medicaid fee-for-service

  • AZ: $1702.21 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $1351.64 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $1267.68 (physician, non-facility), effective Jan 1, 2026
  • IL: $1203.48 (practitioner), effective Apr 1, 2024
  • IN: $1219.78 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $913.13 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $781.31 (physician, facility), effective Jan 1, 2026
  • LA: $1361.72 (professional), effective Jul 1, 2025
  • MA: $1221.87 (physician_surgery), effective May 1, 2024
  • MS: $1322.27 (comprehensive), effective Jul 1, 2026
  • ND: $1621.00 (physician), effective Aug 1, 2026
  • NE: $562.24 (physician, non-facility), effective Jul 1, 2026
  • NY: $757.07 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $892.78 (physician), effective Jan 1, 2024
  • OK: $1403.55 (physician, non-facility), effective Jul 1, 2026
  • TX: $208.31 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2025
  • VA: $1412.04 (medical), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $936.20 (physician, facility), effective Jul 1, 2026
  • WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.