Payer policies › CPT 9259692596 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 92596 Payer coverage policies that name 92596 92596 appears in 1 coverage policy from Premera Blue Cross.
Payer Policy Role in policy Reviewed Document Premera Blue Cross Non-covered Services and ProceduresPage | 9 of 30 | ∞ listed, no stance Jun 1, 2026 payer document
Medicaid fee-for-service Prior authorization required or conditional in WV.
AZ: $24.53 (outpatient_hospital), effective Oct 1, 2021 IL: $48.40 (practitioner), effective Apr 1, 2024 IN: $60.72 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KY: $16.48 (physician, facility), effective Jan 1, 2026 MA: $58.59 (physician_medicine), effective May 1, 2024 MS: $60.53 (comprehensive), effective Jul 1, 2026 ND: $87.49 (physician), effective Aug 1, 2026 NE: $32.90 (physician, non-facility), effective Jul 1, 2026 OK: $33.63 (outpatient_hospital_apc), effective Jan 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WY: $16.52 (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.