62190 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 62190

Payer coverage policies that name 62190

62190 appears in 6 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaAlzheimer's Disease: Experimental, Investigational, or Unproven Treatments (0788)not covered (range 62180-62258)Nov 19, 2025payer document
AetnaIntraoperative Neurophysiological Monitoring (0697)covered if criteria are met (range 62180-62258)Jun 19, 2026payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 61000-64999)Jul 1, 2026payer document
AetnaLysosomal Storage Disorder Treatments (0442)listed, no stance (range 62180-62258)Jul 8, 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

Medicaid fee-for-service

  • AZ: $965.82 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $739.31 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $731.03 (physician, non-facility), effective Jan 1, 2026
  • IL: $839.35 (practitioner), effective Jul 1, 2026
  • IN: $693.96 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $485.05 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $723.13 (physician, facility), effective Jan 1, 2026
  • LA: $153.37 (professional), effective Jul 1, 2025
  • MA: $694.42 (physician_surgery), effective May 1, 2024
  • MS: $765.62 (comprehensive), effective Jul 1, 2026
  • ND: $954.13 (physician), effective Aug 1, 2026
  • NE: $1926.60 (physician, non-facility), effective Jul 1, 2026
  • NY: $410.03 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $593.47 (physician), effective Jan 1, 2024
  • OK: $813.91 (physician, non-facility), effective Jul 1, 2026
  • TX: $801.04 (physician, Physician, facility), effective Mar 1, 2025
  • VA: $820.89 (medical), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $549.22 (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.