90483 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 90483

Payer coverage policies that name 90483

90483 appears in 4 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaDengue Vaccine (1010)listed, no stanceFeb 25, 2026payer document
AetnaInfluenza Vaccines (0035)listed, no stanceOct 8, 2026payer document
AetnaPneumococcal Vaccines (0037)listed, no stanceOct 6, 2026payer document
AetnaVaccines for Travel (0473)listed, no stanceJul 24, 2026payer document

Medicaid fee-for-service

  • AZ: $6.63 (outpatient_hospital, RF133), effective Jan 1, 2026
  • CO: $52.03 (chp_plus_immunizations), effective Jul 1, 2026
  • FL: $22.08 (immunization), effective Jul 1, 2026
  • IN: $47.69 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026
  • ND: $31.17 (physician), effective Aug 1, 2026
  • NY: $35.78 (midwife, non-facility), effective Jul 1, 2026
  • OH: $17.37 (code_changes, facility), effective Jan 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $12.99 (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.