`90589` CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 90589

Payer coverage policies that name 90589

90589 appears in 3 coverage policies from Aetna, Blue Cross & Blue Shield of Rhode Island.

Payer	Policy	Role in policy	Reviewed	Document
Aetna	Injectable Medications (0020)	listed, no stance (range 90581-90658)	Mar 5, 2026	payer document
Aetna	Vaccines for Travel (0473)	covered if criteria are met	Jul 24, 2026	payer document
Blue Cross & Blue Shield of Rhode Island	Immunizations Adult and Pediatric	covered if criteria are met	Jun 9, 2026	payer document

Medicaid fee-for-service

FL: $275.00 (immunization), effective Jul 1, 2026
IN: $245.44 (professional, Advanced Practice Nurse (85%), non-facility), effective Feb 28, 2024
KY: $0.00 (physician, non-facility), effective Jan 1, 2026
ND: $0.00 (physician), effective Aug 1, 2026
OK: $0.00 (physician, non-facility), effective Jul 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.

90589 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 90589

Payer coverage policies that name 90589

Medicaid fee-for-service

`90589` CPT® code: payer coverage and prior authorization