Payer policies › CPT 9220192201 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 92201 Payer coverage policies that name 92201 92201 appears in 4 coverage policies from Aetna, Centene.
Payer Policy Role in policy Reviewed Document Aetna Extended Ophthalmoscopy (0767) covered if criteria are met Dec 2, 2025 payer document Aetna Voretigene Neparvovec-rzyl (Luxturna) (0927) listed, no stance Apr 20, 2026 payer document Centene Extended Ophthalmoscopy covered if criteria are met Jul 1, 2020 payer document Centene Extended Ophthalmoscopy (CP.VP.26) covered if criteria are met Nov 1, 2023 payer document
Medicaid fee-for-service AZ: $2.44 (outpatient_hospital, RF133), effective Oct 1, 2025 CO: $20.39 (chp_plus, non-facility), effective Jul 1, 2026 FL: $15.40 (physician, facility), effective Jan 1, 2026 IL: $15.03 (practitioner), effective Apr 1, 2024 IN: $17.60 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $11.89 (default, Exempt Physician), effective Aug 1, 2024 KY: $18.14 (physician, facility), effective Jan 1, 2026 LA: $21.84 (professional), effective Jan 1, 2020 MA: $16.62 (physician_medicine, facility), effective May 1, 2024 MS: $19.44 (comprehensive), effective Jul 1, 2020 MT: $21.65 (optometric, facility), effective Jul 1, 2025 ND: $27.79 (physician), effective Aug 1, 2026 NE: $43.87 (physician, non-facility), effective Jul 1, 2026 NY: $12.54 (physician_medicine, facility), effective Jul 1, 2026 OH: $20.85 (physician, facility), effective Jan 1, 2024 OK: $16.59 (physician, facility), effective Jul 1, 2026 TX: $17.31 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2025 VA: $15.91 (medical, facility), effective Jul 1, 2026 VT: $45.81 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $10.89 (physician, facility), effective Jul 1, 2026 WY: $26.09 (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.