61650 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 61650

Payer coverage policies that name 61650

61650 appears in 5 coverage policies from Aetna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).

PayerPolicyRole in policyReviewedDocument
AetnaIntraoperative Neurophysiological Monitoring (0697)covered if criteria are met (range 61623-61651)Jun 19, 2026payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 61000-64999)Jul 1, 2026payer document
AetnaRespiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479)listed, no stance (range 61000-64999)Jul 9, 2026payer document
AetnaThermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703)listed, no stance (range 61000-64999)Nov 24, 2025payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Endovascular Procedures for Intracranial Arterial Disease (Atherosclerosis and Aneurysms) (SUR701.027)
CPT Codes 36221, 36222, 36223, 36224, 36225, 36226, 36227, 36228, 61624,
listed, no stanceDec 1, 2025payer document

Medicaid fee-for-service

  • AZ: $593.79 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $443.40 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $407.06 (physician, non-facility), effective Jan 1, 2026
  • IL: $418.61 (practitioner), effective Apr 1, 2024
  • IN: $428.81 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $274.19 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $433.13 (physician, facility), effective Jan 1, 2026
  • LA: $485.70 (professional), effective Jan 1, 2016
  • MA: $413.23 (physician_surgery), effective May 1, 2024
  • MS: $434.62 (comprehensive), effective Jul 1, 2026
  • ND: $517.43 (physician), effective Aug 1, 2026
  • NE: $800.28 (physician, non-facility), effective Jul 1, 2026
  • NY: $305.63 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $457.11 (physician), effective Jan 1, 2024
  • OK: $458.67 (physician, non-facility), effective Jul 1, 2026
  • TX: $465.65 (physician, Physician, facility), effective Mar 1, 2025
  • VA: $453.41 (medical, facility), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $295.82 (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.