65285 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 65285

Medicaid fee-for-service

  • AZ: $2587.16 (asc), effective Oct 1, 2026
  • CO: $879.98 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $750.96 (physician, non-facility), effective Jan 1, 2026
  • IL: $729.32 (practitioner), effective Apr 1, 2024
  • IN: $846.84 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $434.73 (asc, facility), effective Jan 1, 2000
  • KY: $2720.41 (asc), effective Jan 1, 2026
  • LA: $217.00 (asc), effective Jul 1, 2012
  • MA: $1560.46 (asc), effective May 1, 2026
  • MS: $2102.67 (comprehensive, facility), effective Oct 1, 2025
  • MT: $1055.72 (optometric, facility), effective Jul 1, 2025
  • ND: $1603.69 (physician, facility), effective Aug 1, 2026
  • NE: $552.00 (asc), effective Jul 1, 2024
  • NY: $442.28 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $711.92 (physician), effective Jan 1, 2024
  • OK: $2481.89 (asc), effective Jan 1, 2026
  • TX: $1533.49 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $804.98 (medical), effective Jul 1, 2026
  • VT: $4131.79 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $366.60 (asc), effective Jul 1, 2026
  • WY: $2353.28 (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.