Payer policies › CPT 7812278122 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 78122 Medicaid fee-for-service AZ: $279.78 (asc), effective Oct 1, 2026 CO: $25.61 (chp_plus, non-facility), effective Jul 1, 2026 FL: $14.70 (radiology), effective Jan 1, 2026 IL: $63.01 (practitioner), effective Apr 1, 2024 IN: $59.60 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $58.37 (default, Exempt Physician), effective Jan 1, 2024 KY: $292.75 (asc), effective Jan 1, 2026 LA: $114.10 (lab_radiology), effective Jul 1, 2012 MA: $77.84 (physician_radiology), effective May 1, 2024 MS: $233.21 (comprehensive, facility), effective Oct 1, 2025 ND: $112.27 (physician), effective Aug 1, 2026 NE: $195.16 (physician, non-facility), effective Jul 1, 2026 NY: $42.42 (ordered_ambulatory), effective Jul 24, 2026 OH: $81.42 (physician), effective Jan 1, 2018 OK: $85.87 (physician, non-facility), effective Jul 1, 2026 TX: $678.22 (hospital_outpatient_imaging_services, Rural Hospitals), effective Mar 1, 2026 VA: $69.73 (medical), effective Jul 1, 2026 VT: $421.59 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $12.23 (physician, facility), effective Jul 1, 2026 WY: $240.12 (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.