76145 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 76145

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • AZ: $113.16 (asc), effective Oct 1, 2026
  • CO: $835.03 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $745.60 (radiology, non-facility), effective Jan 1, 2026
  • KS: $38.90 (asc, facility), effective Jan 1, 2021
  • KY: $200.03 (asc), effective Jan 1, 2026
  • LA: $680.45 (lab_radiology), effective Jul 1, 2025
  • MA: $727.73 (physician_radiology), effective May 1, 2024
  • MS: $227.98 (comprehensive, facility), effective Oct 1, 2025
  • ND: $1156.89 (physician), effective Aug 1, 2026
  • NE: $879.12 (physician, non-facility), effective Jul 1, 2026
  • NY: $263.51 (ordered_ambulatory), effective Jul 24, 2026
  • OH: $591.80 (physician), effective Jan 1, 2021
  • OK: $866.96 (physician, non-facility), effective Jul 1, 2026
  • TX: $763.43 (miscellaneous_other_professionals_radiation_treatment_center, Miscellaneous Other Professionals - Radiation Treatment Center, facility), effective Mar 1, 2025
  • VA: $900.17 (medical, facility), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $165.02 (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.