Payer policies › CPT 6880168801 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 68801 Payer coverage policies that name 68801 68801 appears in 2 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Dry Eyes (0457)Autologous serum tears covered if criteria are met Jul 29, 2026 payer document Aetna Nasolacrimal Duct Obstruction: Treatments (0420) listed, no stance Jul 7, 2026 payer document
Medicaid fee-for-service AZ: $15.69 (outpatient_hospital, RF133), effective Oct 1, 2025 CO: $78.54 (chp_plus, non-facility), effective Jul 1, 2026 FL: $55.85 (physician, facility), effective Jan 1, 2026 IL: $71.70 (practitioner), effective Jul 1, 2026 IN: $61.36 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $136.50 (asc, facility), effective Jan 1, 1997 KY: $0.00 (asc), effective Jan 1, 2026 LA: $80.79 (professional), effective Feb 1, 2013 MA: $0.00 (asc), effective May 1, 2026 MS: $58.81 (comprehensive), effective Jul 1, 2026 MT: $76.59 (optometric, facility), effective Jul 1, 2025 ND: $105.14 (physician), effective Aug 1, 2026 NE: $96.69 (physician, facility), effective Jul 1, 2026 NY: $47.56 (physician_surgery, facility), effective Jul 1, 2026 OH: $48.16 (physician, facility), effective Jan 1, 2024 OK: $402.28 (outpatient_hospital_apc), effective Jan 1, 2026 TX: $74.19 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Jul 1, 2018 VA: $62.21 (medical, facility), effective Jul 1, 2026 VT: $346.86 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $43.76 (physician, facility), effective Jul 1, 2026 WY: $197.56 (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.