Payer policies › CPT 6168461684 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 61684 Payer coverage policies that name 61684 61684 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 61680-61711) Apr 17, 2026 payer document Aetna Intraoperative Neurophysiological Monitoring (0697) covered if criteria are met (range 61684-61711) Jun 19, 2026 payer document Aetna Intraoperative Neurophysiological Monitoring (0697) covered if criteria are met (range 61680-61711) 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: $2910.35 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $2225.78 (chp_plus, non-facility), effective Jul 1, 2026 FL: $2124.15 (physician, non-facility), effective Jan 1, 2026 IL: $2074.61 (practitioner), effective Apr 1, 2024 IN: $2080.56 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $1944.04 (default), effective Aug 1, 2024 KY: $2034.27 (physician, facility), effective Jan 1, 2026 LA: $468.25 (professional), effective Jul 1, 2025 MA: $2083.18 (physician_surgery), effective May 1, 2024 MS: $2223.44 (comprehensive), effective Jul 1, 2026 ND: $2688.15 (physician), effective Aug 1, 2026 NE: $4816.50 (physician, non-facility), effective Jul 1, 2026 NY: $1346.53 (physician_surgery, facility), effective Jul 1, 2026 OH: $1937.67 (physician), effective Jan 1, 2024 OK: $2357.32 (physician, non-facility), effective Jul 1, 2026 TX: $356.59 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2025 VA: $2366.03 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $1556.32 (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.