Payer policies › CPT 6480964809 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 64809 Payer coverage policies that name 64809 64809 appears in 6 coverage policies from Aetna, Blue Shield of California.
Payer Policy Role in policy Reviewed Document Aetna Hyperhidrosis (0504) covered if criteria are met (range 64802-64823) Aug 11, 2026 payer document Aetna Intravenous Iron Therapy (0575) listed, no stance (range 61000-64999) Jul 1, 2026 payer document Aetna Post-Herpetic Neuralgia (0725) not covered (range 64802-64818) Oct 20, 2025 payer document Aetna Respiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479) listed, no stance (range 61000-64999) Jul 9, 2026 payer document Aetna Thermal Perfusion Probe for Monitoring Regional Cerebral Blood Flow (0703) listed, no stance (range 61000-64999) Nov 24, 2025 payer document Blue Shield of California | Treatment of Hyperhidrosis (8.01.19) listed, no stance payer document
Medicaid fee-for-service Prior authorization required or conditional in NE.
AZ: $1127.60 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $748.26 (chp_plus, non-facility), effective Jul 1, 2026 FL: $561.30 (physician, non-facility), effective Jan 1, 2026 IL: $792.81 (practitioner), effective Apr 1, 2024 IN: $809.09 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $318.50 (default, Exempt Physician), effective Aug 1, 2024 KY: $707.85 (physician, facility), effective Jan 1, 2026 LA: $898.59 (professional), effective Jul 1, 2025 MA: $810.28 (physician_surgery), effective May 1, 2024 MS: $885.93 (comprehensive), effective Jul 1, 2026 ND: $1095.31 (physician), effective Aug 1, 2026 NE: $325.51 (physician, non-facility), effective Jul 1, 2026 NY: $411.95 (physician_surgery, facility), effective Jul 1, 2026 OH: $647.87 (physician), effective Jan 1, 2000 OK: $940.97 (physician, non-facility), effective Jul 1, 2026 TX: $137.83 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2025 VA: $947.92 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $631.59 (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.