94015 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 94015

Payer coverage policies that name 94015

94015 appears in 7 coverage policies from Aetna, Blue Cross & Blue Shield of Rhode Island.

PayerPolicyRole in policyReviewedDocument
AetnaBenralizumab (Fasenra) (0925)listed, no stance (range 94010-94799)Aug 25, 2026payer document
AetnaHome/Ambulatory Spirometry (0572)covered if criteria are metSep 1, 2026payer document
AetnaOxygen (0002)listed, no stance (range 94010-94777)Mar 10, 2026payer document
AetnaPulmonary Rehabilitation (0032)listed, no stance (range 94010-94621)Mar 5, 2026payer document
AetnaRespiratory Devices: Incentive Spirometers, Vaporizers and Intermittent Positive Pressure Breathing Machines (0479)listed, no stance (range 94010-94621)Jul 9, 2026payer document
AetnaTotal Body Plethysmography (0474)listed, no stance (range 94010-94070)Jul 17, 2026payer document
Blue Cross & Blue Shield of Rhode IslandHome Spirometrynot coveredJan 21, 2026payer document

Medicaid fee-for-service

  • AZ: $191.73 (outpatient_hospital), effective Oct 1, 2021
  • CO: $23.63 (chp_plus, non-facility), effective Jul 1, 2026
  • IL: $28.82 (practitioner), effective Apr 1, 2024
  • IN: $24.22 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • LA: $23.96 (professional), effective Jul 1, 2025
  • MA: $24.57 (physician_medicine), effective May 1, 2024
  • MS: $27.14 (comprehensive), effective Jul 1, 2026
  • ND: $39.05 (physician), effective Aug 1, 2026
  • NE: $54.84 (physician, non-facility), effective Jul 1, 2026
  • NY: $7.58 (ordered_ambulatory), effective Jul 24, 2026
  • OH: $15.58 (physician), effective Jan 1, 2024
  • TX: $24.78 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2025
  • VT: $167.66 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $22.17 (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.