Payer policies › CPT 9038490384 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 90384 Payer coverage policies that name 90384 90384 appears in 2 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Immune Globulins for Post-Exposure Prophylaxis (0544) covered if criteria are met Oct 7, 2026 payer document Aetna Injectable Medications (0020) listed, no stance (range 90281-90399) Mar 5, 2026 payer document
Medicaid fee-for-service AZ: $85.31 (outpatient_hospital), effective Jan 1, 2026 CO: $130.72 (chp_plus_immunizations), effective Jul 1, 2026 IL: $76.89 (practitioner), effective Apr 1, 2026 IN: $76.14 (professional, Advanced Practice Nurse (85%), non-facility), effective Apr 1, 2026 KS: $85.31 (default), effective Apr 1, 2026 KY: $45.00 (asc), effective Jan 1, 2026 MS: $75.52 (comprehensive), effective Jul 1, 2020 ND: $0.00 (physician), effective Aug 1, 2026 OH: $112.13 (provider_administered_drugs), effective Sep 1, 2013 VA: $112.09 (medical), effective Jan 1, 2000 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.