`90296` CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 90296

Payer coverage policies that name 90296

90296 appears in 1 coverage policy from Aetna.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Injectable Medications (0020)	listed, no stance (range 90281-90399)	Mar 5, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

CO: $45.49 (chp_plus_immunizations), effective Jul 1, 2026
ND: $0.00 (physician), effective Aug 1, 2026
OK: $300.65 (asc), effective Jan 1, 2026
VT: $0.00 (outpatient_hospital_opps), effective Feb 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.

90296 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 90296

Payer coverage policies that name 90296

Medicaid fee-for-service

`90296` CPT® code: payer coverage and prior authorization