72070 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 72070

Payer coverage policies that name 72070

72070 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaHyperbaric Oxygen Therapy (HBOT) (0172)listed, no stanceApr 21, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in WV.

  • AZ: $79.00 (outpatient_hospital), effective Oct 1, 2021
  • CO: $19.80 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $17.29 (radiology), effective Jan 1, 2026
  • IL: $22.80 (practitioner), effective Apr 1, 2024
  • IN: $25.29 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $6.00 (default, Exempt Physician), effective Jan 1, 2024
  • KY: $0.00 (asc), effective Jan 1, 2026
  • LA: $25.41 (lab_radiology), effective Jul 1, 2025
  • MA: $18.68 (physician_radiology), effective May 1, 2024
  • MS: $8.31 (comprehensive), effective Jul 1, 2026
  • ND: $25.91 (physician), effective Aug 1, 2026
  • NE: $45.33 (chiropractor, non-facility), effective Jul 1, 2026
  • NY: $15.15 (ordered_ambulatory), effective Jul 24, 2026
  • OH: $26.44 (physician), effective Jan 1, 2024
  • OK: $28.24 (physician, non-facility), effective Jul 1, 2026
  • TX: $131.99 (hospital_outpatient_imaging_services, Rural Hospitals), effective Mar 1, 2025
  • VA: $8.39 (medical), effective Jul 1, 2026
  • VT: $81.18 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $14.71 (chiropractic_services_for_children, non-facility), effective Jul 1, 2026
  • WY: $46.23 (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.