Payer policies › CPT 9930499304 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 99304 Payer coverage policies that name 99304 99304 appears in 2 coverage policies from Blue Cross NC, Centene.
Payer Policy Role in policy Reviewed Document Blue Cross NC Evaluation and Management Services listed, no stance (range 99202-99499) Jun 1, 2026 payer document Centene Skilled Nursing Facility Leveling (CP.MP.206) covered if criteria are met Aug 1, 2022 payer document
Medicaid fee-for-service AZ: $70.21 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $135.79 (chp_plus, non-facility), effective Jul 1, 2026 FL: $63.12 (physician, non-facility), effective Jan 1, 2026 IL: $54.23 (practitioner), effective Apr 1, 2024 IN: $62.61 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $44.15 (default, Exempt Physician), effective Aug 1, 2024 KY: $49.40 (physician, facility), effective Jan 1, 2026 LA: $66.63 (professional), effective Feb 1, 2013 MA: $59.55 (physician_medicine), effective May 1, 2024 MS: $76.48 (comprehensive, PCP), effective Jul 1, 2026 ND: $89.37 (physician), effective Aug 1, 2026 NE: $107.71 (behavioral_health, Advanced Practice Registered Nurse (APRN)), effective NY: $30.11 (midwife, facility), effective Jul 1, 2026 OH: $44.47 (physician), effective Jan 1, 2024 OK: $64.18 (physician, facility), effective Jul 1, 2026 TX: $48.49 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), non-facility), effective Sep 1, 2023 VA: $58.54 (medical), effective Jul 1, 2026 VT: $58.98 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $49.31 (enhanced_adult, facility), effective Jul 1, 2026 WY: $0.00 (outpatient_hospital_apc, Children's Hospitals), 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.