64802 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 64802

1 of 1 payer prior-auth lists that name 64802 require prior authorization or set conditions: Blue Cross and Blue Shield of Texas.

PayerPlanStatePrior authConditionsSinceSource
Blue Cross and Blue Shield of TexasTexas PA exemption (gold card), outpatient, fully insuredTXprior auth requiredGold-card exemption availableJul 1, 2026BCBSTX Outpatient Prior Authorization Exemption Clinical Guidelines (max units, PA exempt date range)

Payer coverage policies that name 64802

64802 appears in 7 coverage policies from Aetna, Blue Shield of California.

PayerPolicyRole in policyReviewedDocument
AetnaHeadaches: Invasive Procedures (0707)
There is no specific code for Ganglionectomy
not coveredJul 23, 2026payer document
AetnaHyperhidrosis (0504)covered if criteria are met (range 64802-64823)Aug 11, 2026payer document
AetnaIntravenous Iron Therapy (0575)listed, no stance (range 61000-64999)Jul 1, 2026payer document
AetnaPost-Herpetic Neuralgia (0725)not covered (range 64802-64818)Oct 20, 2025payer 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
Blue Shield of California| Treatment of Hyperhidrosis (8.01.19)listed, no stancepayer document

Medicaid fee-for-service

  • AZ: $556.61 (asc), effective Oct 1, 2026
  • CO: $542.49 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $408.34 (physician, non-facility), effective Jan 1, 2026
  • IL: $610.54 (practitioner), effective Apr 1, 2024
  • IN: $634.09 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $400.00 (asc, facility), effective Aug 1, 1982
  • 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
  • NY: $289.80 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $397.48 (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: $761.57 (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.