64740 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 64740

Payer coverage policies that name 64740

64740 appears in 5 coverage policies from Aetna, Anthem.

PayerPolicyRole in policyReviewedDocument
AetnaFacial Nerve Paralysis (0745)not covered (range 64732-64740)Oct 30, 2025payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 61000-64999)Jul 1, 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
AnthemCosmetic and Reconstructive Services of the Head and Neck (ANC.00008)covered if criteria are met (range 64732-64742)Aug 13, 2026payer document

Medicaid fee-for-service

  • AZ: $556.61 (asc), effective Oct 1, 2026
  • CO: $187.05 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $334.84 (physician, non-facility), effective Jan 1, 2026
  • IL: $307.38 (practitioner), effective Apr 1, 2024
  • IN: $358.39 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $272.26 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $926.03 (asc), effective Jan 1, 2026
  • LA: $182.30 (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: $413.00 (asc), effective Jul 1, 2024
  • OH: $281.69 (physician), effective Jan 1, 2000
  • 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: $372.97 (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.