66155 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 66155

Payer coverage policies that name 66155

66155 appears in 1 coverage policy from Aetna.

Medicaid fee-for-service

• AZ: $1525.68 (asc), effective Oct 1, 2026
• CO: $523.78 (chp_plus, non-facility), effective Jul 1, 2026
• FL: $591.76 (physician, non-facility), effective Jan 1, 2026
• IL: $718.70 (practitioner), effective Jul 1, 2026
• IN: $671.81 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
• KS: $432.56 (default, Exempt Physician), effective Aug 1, 2024
• KY: $2151.31 (asc), effective Jan 1, 2026
• LA: $217.00 (asc), effective Jul 1, 2012
• MA: $1560.46 (asc), effective May 1, 2026
• MS: $1675.46 (comprehensive, facility), effective Oct 1, 2025
• MT: $840.04 (optometric, facility), effective Jul 1, 2025
• ND: $1268.20 (physician, facility), effective Aug 1, 2026
• NE: $552.00 (asc), effective Jul 1, 2024
• NY: $370.60 (physician_surgery, facility), effective Jul 1, 2026
• OH: $461.71 (physician), effective Jan 1, 2000
• OK: $1962.68 (asc), effective Jan 1, 2026
• TX: $2206.78 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
• VA: $659.14 (medical), effective Jul 1, 2026
• VT: $3209.44 (outpatient_hospital_opps), effective Feb 1, 2026
• WA: $339.40 (asc), effective Jul 1, 2026
• WY: $1827.95 (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.