64468 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 64468

Payer coverage policies that name 64468

64468 appears in 6 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaInfusion Pumps (0161)covered if criteria are met (range 64400-64530)Mar 31, 2026payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 61000-64999)Jul 1, 2026payer document
AetnaNerve Blocks (0863)covered if criteria are metJul 23, 2026payer document
AetnaNerve Blocks (0863)not coveredJul 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
AetnaSpinal Ultrasound (0628)listed, no stance (range 64400-64530)Sep 11, 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

Prior authorization required or conditional in WV.

  • AZ: $71.13 (outpatient_hospital, RF133), effective Oct 1, 2025
  • IL: $50.25 (practitioner), effective Jan 1, 2025
  • IN: $57.18 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $82.37 (default), effective Jan 1, 2025
  • KY: $0.00 (asc), effective Jan 1, 2026
  • LA: $116.03 (professional), effective Jan 1, 2025
  • MA: $0.00 (asc), effective May 1, 2026
  • MS: $133.61 (comprehensive), effective Jul 1, 2026
  • ND: $181.36 (physician), effective Aug 1, 2026
  • NE: $155.60 (physician, non-facility), effective Jul 1, 2026
  • NY: $37.98 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $55.24 (physician, facility), effective Jan 1, 2025
  • OK: $61.88 (physician, facility), effective Jul 1, 2026
  • TX: $56.55 (certified_registered_nurse_anesthetist_crna_anesthesiologist, Certified Registered Nurse Anesthetist (Crna) / Anesthesiologist Assistant (Aa), facility), effective Jan 1, 2025
  • VA: $59.03 (medical, facility), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $39.56 (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.