90840 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 90840

Payer coverage policies that name 90840

90840 appears in 9 coverage policies from Aetna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).

PayerPolicyRole in policyReviewedDocument
AetnaAutism Spectrum Disorders (0648)covered if criteria are met (range 90832-90840)Oct 2, 2025payer document
AetnaEye Movement Desensitization and Reprocessing (EMDR) Therapy (0583)listed, no stance (range 90832-90899)Sep 18, 2026payer document
AetnaHyperhidrosis (0504)not covered (range 90832-90853)Aug 11, 2026payer document
AetnaIntensive Cardiac Rehabilitation Programs (0267)listed, no stance (range 90832-90840)May 14, 2026payer document
AetnaPediatric Intensive Feeding Programs (0809)listed, no stanceDec 11, 2025payer document
AetnaTemporomandibular Disorders (0028)covered if criteria are met (range 90832-90840)Mar 12, 2026payer document
AetnaTourette's Syndrome (0480)covered if criteria are metJul 24, 2026payer document
AetnaTranscranial Magnetic Stimulation and Cranial Electrical Stimulation (0469)listed, no stance (range 90839-90840)Jul 17, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Medical Policies Moving to MCG Guidelines
Spectrum Disorders (ASD) | 70460, 70470, 70496, 70551, | Disorders – Gene Panels
listed, no stanceJan 1, 2026payer document

Medicaid fee-for-service

  • CO: $59.48 (chp_plus_behavioral), effective Jul 1, 2026
  • IN: $53.50 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $46.76 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $56.21 (behavioral_health, billed with AF/AM), effective Jul 15, 2026
  • LA: $10.00 (epsdt), effective Mar 6, 2023
  • MA: $45.56 (physician_medicine, facility), effective May 1, 2024
  • ND: $86.36 (physician), effective Aug 1, 2026
  • NE: $57.74 (behavioral_health, Advanced Practice Registered Nurse (APRN)), effective
  • OH: $46.85 (physician, facility), effective Jan 1, 2024
  • VA: $66.36 (medical, facility), effective Jan 1, 2024
  • 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.