Payer policies › CPT 9099790997 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 90997 Payer coverage policies that name 90997 90997 appears in 3 coverage policies from Aetna.
Payer Policy Role in policy Reviewed Document Aetna Daprodustat (Jesduvroq) (1044) listed, no stance (range 90935-90999) Jan 27, 2026 payer document Aetna Marnetegragene Autotemcel (Kresladi) (1102) listed, no stance (range 90935-90997) Jul 13, 2026 payer document Aetna Pancreas Kidney Transplantation (0587) listed, no stance (range 90935-90999) Sep 8, 2026 payer document
Medicaid fee-for-service AZ: $90.31 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $71.37 (chp_plus, non-facility), effective Jul 1, 2026 IN: $68.92 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KY: $120.91 (physician, facility), effective Jan 1, 2026 LA: $74.05 (professional), effective Feb 1, 2013 MA: $64.39 (physician_medicine), effective May 1, 2024 MS: $66.09 (comprehensive), effective Jul 1, 2026 ND: $82.98 (physician), effective Aug 1, 2026 NE: $493.56 (physician, non-facility), effective Jul 1, 2026 OH: $78.98 (physician), effective Jan 1, 2010 TX: $73.54 (physician, Physician, non-facility), effective Sep 1, 2025 VA: $65.97 (medical), effective Jul 1, 2026 VT: $62.93 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $44.72 (physician, 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.