63702 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 63702

Payer coverage policies that name 63702

63702 appears in 5 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaIntraoperative Neurophysiological Monitoring (0697)not covered (range 62263-63746)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 62263-63746)Jul 23, 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: $1483.24 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $1136.02 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $1115.98 (physician, non-facility), effective Jan 1, 2026
  • IL: $1043.17 (practitioner), effective Apr 1, 2024
  • IN: $1064.20 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $515.65 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $918.85 (physician, facility), effective Jan 1, 2026
  • LA: $1182.23 (professional), effective Jul 1, 2025
  • MA: $1065.78 (physician_surgery), effective May 1, 2024
  • MS: $1161.73 (comprehensive), effective Jul 1, 2026
  • ND: $1435.13 (physician), effective Aug 1, 2026
  • NE: $414.28 (physician, non-facility), effective Jul 1, 2026
  • NY: $626.57 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $905.04 (physician), effective Jan 1, 2024
  • OK: $1234.11 (physician, non-facility), effective Jul 1, 2026
  • TX: $172.66 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2025
  • VA: $1243.06 (medical), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $827.65 (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.