71100 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 71100

Medicaid fee-for-service

Prior authorization required or conditional in WV.

  • AZ: $58.65 (outpatient_hospital), effective Oct 1, 2021
  • CO: $22.07 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $16.88 (radiology), effective Jan 1, 2026
  • IL: $47.30 (practitioner), effective Apr 1, 2024
  • IN: $19.65 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $22.01 (default, Exempt Physician), effective Jan 1, 2024
  • KY: $0.00 (asc), effective Jan 1, 2026
  • LA: $28.22 (lab_radiology), effective Jul 1, 2025
  • MA: $8.00 (physician_radiology), effective May 1, 2024
  • MS: $66.09 (comprehensive), effective Jul 1, 2026
  • ND: $28.54 (physician), effective Aug 1, 2026
  • NE: $27.87 (physician, non-facility), effective Jul 1, 2026
  • NY: $15.15 (ordered_ambulatory), effective Jul 24, 2026
  • OH: $24.66 (physician), effective Jan 1, 2024
  • OK: $21.47 (physician, non-facility), effective Jul 1, 2026
  • TX: $109.09 (hospital_outpatient_imaging_services, Rural Hospitals), effective Mar 1, 2025
  • VA: $31.25 (medical), effective Jul 1, 2026
  • VT: $67.57 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $16.24 (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.