64822 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 64822

Payer coverage policies that name 64822

64822 appears in 4 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
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
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

Medicaid fee-for-service

  • AZ: $1062.88 (asc), effective Oct 1, 2026
  • CO: $563.30 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $513.57 (physician, non-facility), effective Jan 1, 2026
  • IL: $483.46 (practitioner), effective Apr 1, 2024
  • IN: $540.57 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KY: $1605.64 (asc), effective Jan 1, 2026
  • LA: $566.36 (professional), effective Jul 1, 2025
  • MA: $1093.32 (asc), effective May 1, 2026
  • MS: $1263.33 (comprehensive, facility), effective Oct 1, 2025
  • ND: $946.52 (physician, facility), effective Aug 1, 2026
  • NE: $815.10 (physician, non-facility), effective Jul 1, 2026
  • NY: $323.85 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $464.37 (physician), effective Jan 1, 2024
  • OK: $575.53 (physician, non-facility), effective Jul 1, 2026
  • TX: $1088.27 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $572.05 (medical), effective Jul 1, 2026
  • VT: $2540.58 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), effective Jul 1, 2026
  • WY: $1447.00 (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.