Payer policies › CPT 7436374363 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 74363 Medicaid fee-for-service AZ: $272.42 (physician, AHCCCS PT 08, facility), effective Oct 1, 2020 CO: $32.05 (chp_plus, non-facility), effective Jul 1, 2026 FL: $27.94 (radiology), effective Jan 1, 2026 IL: $132.47 (practitioner), effective Apr 1, 2024 IN: $31.08 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $25.52 (default, Exempt Physician), effective Jan 1, 2024 KY: $0.00 (asc), effective Jan 1, 2026 LA: $295.99 (lab_radiology), effective Jul 1, 2012 MA: $30.65 (physician_radiology), effective May 1, 2024 MS: $157.55 (comprehensive), effective Jul 1, 2026 ND: $41.68 (physician), effective Aug 1, 2026 NE: $329.42 (physician, non-facility), effective Jul 1, 2026 NY: $80.80 (ordered_ambulatory), effective Jul 24, 2026 OH: $198.64 (physician), effective Jan 1, 2018 OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026 TX: $113.93 (miscellaneous_other_professionals_portable_x_ray_radiologica, Miscellaneous Other Professionals - Portable X-Ray, Radiological Lab, Physiological Lab, non-facility), effective Sep 1, 2023 VA: $215.86 (medical), effective Jul 1, 2009 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $22.55 (physician, facility), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.