76936 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 76936

Medicaid fee-for-service

  • AZ: $66.18 (asc), effective Oct 1, 2026
  • CO: $75.19 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $123.95 (radiology), effective Jan 1, 2026
  • IL: $169.86 (practitioner), effective Apr 1, 2024
  • IN: $124.86 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $153.76 (default, Mid Level Practitioner), effective Jan 1, 2024
  • KY: $116.45 (asc), effective Jan 1, 2026
  • LA: $213.11 (lab_radiology), effective Jul 1, 2012
  • MA: $133.65 (physician_radiology), effective May 1, 2024
  • MS: $127.06 (comprehensive, facility), effective Oct 1, 2025
  • ND: $68.65 (physician, facility), effective Aug 1, 2026
  • NE: $159.34 (physician, non-facility), effective Jul 1, 2026
  • NY: $268.05 (physician_radiology, facility), effective Apr 1, 2026
  • OH: $212.03 (physician), effective Jan 1, 2018
  • OK: $106.24 (asc), effective Jan 1, 2026
  • TX: $376.82 (hospital_outpatient_imaging_services, Rural Hospitals), effective Mar 1, 2025
  • VA: $229.46 (medical), effective Jul 1, 2026
  • VT: $167.66 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $54.46 (physician, facility), effective Jul 1, 2026
  • WY: $95.49 (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.