71045 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 71045

Payer coverage policies that name 71045

71045 appears in 18 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaAbatacept (Orencia) (0720)listed, no stance (range 71045-71048)Jul 1, 2026payer document
AetnaAdalimumab (0655)listed, no stance (range 71045-71048)Jul 13, 2026payer document
AetnaCanakinumab (Ilaris) (0881)listed, no stanceAug 3, 2026payer document
AetnaCertolizumab Pegol (Cimzia) (0761)listed, no stance (range 71045-71048)Jul 1, 2026payer document
AetnaEtanercept (0315)
CD11c expression and DNA methylation as biomarkers of etanercept response		listed, no stance (range 71045-71048)Jul 8, 2026payer document
AetnaGolimumab (Simponi and Simponi Aria) (0790)listed, no stance (range 71045-71048)Jul 31, 2026payer document
AetnaGuselkumab (Tremfya) (1011)listed, no stance (range 71045-71048)Jun 29, 2026payer document
AetnaInfliximab (0341)listed, no stance (range 71045-71048)Oct 5, 2026payer document
AetnaLung Cancer Screening (0380)listed, no stance (range 71045-71048)May 28, 2026payer document
AetnaMirikizumab-mrkz (Omvoh) (1048)listed, no stance (range 71045-71048)Jul 1, 2026payer document
AetnaRisankizumab-rzaa (Skyrizi) (1009)listed, no stance (range 71045-71048)Jul 1, 2026payer document
AetnaSecukinumab (Cosentyx) (0905)listed, no stance (range 71045-71048)Aug 11, 2026payer document
AetnaSpesolimab-sbzo (Spevigo) (1013)listed, no stance (range 71045-71048)Apr 2, 2026payer document
AetnaTildrakizumab-asmn (Ilumya) (1012)listed, no stance (range 71045-71048)Jul 1, 2026payer document
AetnaTocilizumab (0799)listed, no stance (range 71045-71048)Jun 30, 2026payer document
AetnaTuberculosis Testing (0471)listed, no stance (range 71045-71048)Jul 23, 2026payer document
AetnaUstekinumab (0912)listed, no stance (range 71045-71048)Jul 1, 2026payer document
AetnaVedolizumab (Entyvio) (0885)listed, no stance (range 71045-71048)Jun 30, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in WV.

  • AZ: $9.18 (asc), effective Oct 1, 2026
  • CO: $21.80 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $9.74 (radiology), effective Jan 1, 2026
  • IL: $16.22 (practitioner), effective Apr 1, 2024
  • IN: $6.86 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $6.79 (asc, facility), effective Jan 1, 2018
  • KY: $16.38 (asc), effective Jan 1, 2026
  • LA: $19.86 (lab_radiology), effective Jul 1, 2025
  • MA: $6.48 (physician_radiology), effective May 1, 2024
  • MS: $13.20 (comprehensive, facility), effective Oct 1, 2025
  • ND: $16.20 (physician, facility), effective Aug 1, 2026
  • NE: $39.07 (physician, non-facility), effective Jul 1, 2026
  • NY: $10.10 (ordered_ambulatory), effective Jul 24, 2026
  • OH: $14.98 (physician), effective Jan 1, 2024
  • OK: $14.21 (physician, non-facility), effective Jul 1, 2026
  • TX: $6.68 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), facility), effective Mar 1, 2025
  • VA: $21.99 (medical), effective Jul 1, 2026
  • VT: $67.57 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $4.97 (physician, facility), effective Jul 1, 2026
  • WY: $38.49 (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.