Payer policies › CPT 9067590675 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 90675 Payer coverage policies that name 90675 90675 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 90666-90676) 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 AZ: $303.76 (asc), effective Oct 1, 2026 CO: $338.14 (chp_plus_immunizations), effective Jul 1, 2026 FL: $319.75 (immunization), effective Jul 1, 2026 IL: $315.22 (practitioner), effective Apr 1, 2026 IN: $387.89 (professional, Advanced Practice Nurse (85%), non-facility), effective Oct 1, 2025 KS: $327.99 (default), effective Oct 1, 2026 KY: $319.75 (asc), effective Jan 1, 2026 MS: $249.62 (comprehensive, facility), effective Oct 1, 2025 ND: $331.98 (physician), effective Aug 1, 2026 OH: $315.22 (provider_administered_drugs), effective Jul 1, 2026 OK: $310.83 (physician, non-facility), effective Jul 1, 2026 TX: $286.17 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2026 VA: $331.97 (medical), effective Jul 1, 2026 VT: $238.40 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $331.98 (professional_administered_drugs), effective Jul 1, 2026 WY: $136.45 (outpatient_hospital_apc, Ambulatory Surgical Centers), 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.