Payer policies › CPT 9086590865 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 90865 Payer coverage policies that name 90865 90865 appears in 1 coverage policy from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Eye Movement Desensitization and Reprocessing (EMDR) Therapy (0583) listed, no stance (range 90832-90899) Sep 18, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in IN.
IL: $83.22 (practitioner), effective Apr 1, 2024 KS: $95.26 (default, Exempt Physician), effective Aug 1, 2024 KY: $121.79 (behavioral_health, billed with AF/AM), effective Jul 15, 2026 MA: $89.88 (physician_medicine, facility), effective May 1, 2024 ND: $188.87 (physician), effective Aug 1, 2026 OK: $104.82 (physician, facility), effective Jul 1, 2026 VA: $117.12 (medical, facility), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $67.27 (mental_health_services, facility), effective Jul 1, 2026 WY: $78.50 (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.