Payer policies › CPT 7560575605 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 75605 Medicaid fee-for-service AZ: $3458.52 (outpatient_hospital), effective Oct 1, 2021 CO: $100.20 (chp_plus, non-facility), effective Jul 1, 2026 FL: $53.51 (radiology), effective Jan 1, 2026 IL: $79.37 (practitioner), effective Apr 1, 2024 IN: $51.22 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $71.88 (default, Exempt Physician), effective Jan 1, 2024 KY: $0.00 (asc), effective Jan 1, 2026 LA: $116.31 (lab_radiology), effective Jul 1, 2012 MA: $38.68 (physician_radiology), effective May 1, 2024 MS: $53.24 (comprehensive), effective Jul 1, 2026 ND: $132.92 (physician), effective Aug 1, 2026 NE: $584.32 (physician, non-facility), effective Jul 1, 2026 NY: $50.50 (ordered_ambulatory), effective Jul 24, 2026 OH: $115.63 (physician), effective Jan 1, 2024 OK: $104.30 (physician, non-facility), effective Jul 1, 2026 TX: $6597.26 (hospital_outpatient_imaging_services, Rural Hospitals), effective Mar 1, 2025 VA: $45.14 (medical), effective Jul 1, 2026 VT: $4320.61 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $43.38 (physician, facility), effective Jul 1, 2026 WY: $2460.82 (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.