92020 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 92020

Payer coverage policies that name 92020

92020 appears in 3 coverage policies from Aetna, Centene.

PayerPolicyRole in policyReviewedDocument
AetnaCorneal Pachymetry (0681)listed, no stanceOct 15, 2025payer document
AetnaGlaucoma Testing (0622)covered if criteria are metSep 23, 2026payer document
CenteneGonioscopy (CP.VP.31)covered if criteria are metNov 1, 2023payer document

Medicaid fee-for-service

  • AZ: $7.32 (outpatient_hospital, RF133), effective Oct 1, 2025
  • CO: $22.47 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $13.79 (physician, facility), effective Jan 1, 2026
  • IL: $19.14 (practitioner), effective Apr 1, 2024
  • IN: $15.89 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $17.91 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $14.99 (physician, facility), effective Jan 1, 2026
  • LA: $21.72 (professional), effective Jul 1, 2025
  • MA: $15.15 (physician_medicine, facility), effective May 1, 2024
  • MS: $17.76 (comprehensive), effective Jul 1, 2020
  • MT: $19.40 (optometric, facility), effective Jul 1, 2025
  • ND: $29.66 (physician), effective Aug 1, 2026
  • NE: $43.75 (physician, facility), effective Jul 1, 2026
  • NY: $8.08 (ordered_ambulatory), effective Jul 24, 2026
  • OH: $11.71 (physician, facility), effective Jan 1, 2024
  • OK: $14.85 (physician, facility), effective Jul 1, 2026
  • TX: $15.49 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective May 1, 2016
  • VA: $14.18 (medical, facility), effective Jul 1, 2026
  • VT: $103.31 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $9.75 (physician, facility), effective Jul 1, 2026
  • WY: $58.84 (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.