Payer policies › CPT 9068090680 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 90680 Payer coverage policies that name 90680 90680 appears in 2 coverage policies from Aetna, Blue Cross & Blue Shield of Rhode Island.
Payer Policy Role in policy Reviewed Document Aetna Rotavirus Vaccine (0723) covered if criteria are met Nov 25, 2025 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: $102.74 (outpatient_hospital), effective Oct 1, 2025 CO: $0.00 (immunizations), effective Jul 1, 2026 FL: $0.00 (immunization), effective Jul 1, 2026 IL: $16.26 (practitioner), effective Apr 1, 2025 IN: $0.00 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020 KS: $0.01 (default), effective Sep 1, 2005 KY: $0.00 (asc), effective Jan 1, 2026 LA: $0.00 (immunization_0_18), effective Jul 28, 2006 ND: $0.00 (physician), effective Aug 1, 2026 OK: $0.00 (outpatient_hospital_apc), effective Jan 1, 2026 VA: $87.88 (medical), effective Feb 11, 2021 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $2.67 (enhanced_pediatric, 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.