64708 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 64708

Payer coverage policies that name 64708

64708 appears in 11 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaComplex Regional Pain Syndrome (CRPS): Treatments (0447)not covered (range 64702-64727)Jul 16, 2026payer document
AetnaDiabetic Neuropathy: Selected Treatments (0729)not coveredFeb 24, 2026payer document
AetnaGender Affirming Surgery (0615)covered if criteria are metSep 8, 2026payer document
AetnaHeadaches: Invasive Procedures (0707)not covered (range 64702-64727)Jul 23, 2026payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 61000-64999)Jul 1, 2026payer document
AetnaLaser Neurolysis (0552)listed, no stance (range 64708-64714)Aug 3, 2026payer document
AetnaRespiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479)listed, no stance (range 61000-64999)Jul 9, 2026payer document
AetnaSpasticity Management (0362)covered if criteria are met (range 64708-64714)May 26, 2026payer document
AetnaThermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703)listed, no stance (range 61000-64999)Nov 24, 2025payer document
AetnaUltrasound Guidance – Selected Indications (0952)not coveredApr 27, 2026payer document
AetnaWinged Scapula (0859)not coveredDec 9, 2025payer document

Medicaid fee-for-service

Prior authorization required or conditional in WA.

  • AZ: $556.61 (asc), effective Oct 1, 2026
  • CO: $405.66 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $361.08 (physician, non-facility), effective Jan 1, 2026
  • IL: $496.12 (practitioner), effective Apr 1, 2024
  • IN: $395.76 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $410.00 (asc, facility), effective Aug 1, 1982
  • KY: $926.03 (asc), effective Jan 1, 2026
  • LA: $233.58 (asc), effective Jul 1, 2012
  • MA: $677.27 (asc), effective May 1, 2026
  • MS: $739.94 (comprehensive, facility), effective Oct 1, 2025
  • ND: $545.90 (physician, facility), effective Aug 1, 2026
  • NE: $1233.00 (asc), effective Jul 1, 2024
  • NY: $218.87 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $366.68 (physician), effective Jan 1, 2024
  • OK: $844.84 (asc), effective Jan 1, 2026
  • TX: $659.94 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $402.20 (medical), effective Jul 1, 2026
  • VT: $1516.22 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $308.28 (asc), effective Jul 1, 2026
  • WY: $863.57 (outpatient_hospital_apc, Ambulatory Surgical Centers), 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.