Payer policies › CPT 9251692516 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 92516 Medicaid fee-for-service AZ: $51.26 (outpatient_hospital, RF133), effective Oct 1, 2025 CO: $21.09 (chp_plus, non-facility), effective Jul 1, 2026 FL: $15.40 (physician, facility), effective Jan 1, 2026 IL: $15.90 (practitioner), effective Jul 1, 2026 IN: $17.54 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $39.51 (default, Exempt Physician), effective Aug 1, 2024 KY: $52.13 (audiology), effective Jan 1, 2026 MA: $16.95 (physician_medicine, facility), effective May 1, 2024 MS: $59.88 (comprehensive), effective Jul 1, 2026 ND: $83.73 (physician), effective Aug 1, 2026 NE: $15.45 (physician, facility), effective Jul 1, 2026 OH: $19.69 (physician, facility), effective Jan 1, 2024 OK: $16.94 (physician, facility), effective Jul 1, 2026 TX: $16.48 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Mar 1, 2026 VA: $16.20 (medical, facility), effective Jul 1, 2026 VT: $167.66 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $10.89 (physician, facility), effective Jul 1, 2026 WY: $95.49 (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.