78350 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 78350

Payer coverage policies that name 78350

78350 appears in 5 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross NC.

Medicaid fee-for-service

• AZ: $32.77 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
• FL: $17.05 (radiology), effective Jan 1, 2026
• IL: $124.50 (practitioner), effective Jul 1, 2026
• IN: $8.47 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
• KS: $13.98 (default, Exempt Physician), effective Jan 1, 1995
• KY: $45.00 (asc), effective Jan 1, 2026
• MA: $24.80 (physician_radiology), effective May 1, 2024
• MS: $8.86 (comprehensive), effective Jul 1, 2026
• ND: $0.00 (physician), effective Aug 1, 2026
• NY: $40.40 (ordered_ambulatory), effective Jul 24, 2026
• OH: $29.38 (physician), effective Jan 1, 2018
• OK: $28.28 (physician, non-facility), effective Jul 1, 2026
• TX: $25.66 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), non-facility), effective Mar 1, 2026
• VA: $19.39 (medical), effective Jul 1, 2026
• VT: $18.83 (outpatient_hospital_opps), effective Feb 1, 2026
• WA: $6.31 (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.