Payer policies › CPT 9941599415 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 99415 Payer coverage policies that name 99415 99415 appears in 1 coverage policy from Blue Cross NC.
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
Medicaid fee-for-service Prior authorization required or conditional in IN.
CO: $8.61 (chp_plus, non-facility), effective Jul 1, 2026 FL: $10.11 (physician, non-facility), effective Jan 1, 2026 KY: $7.46 (physician, facility), effective Jan 1, 2026 LA: $15.51 (professional), effective Jul 1, 2025 MA: $14.93 (physician_medicine), effective May 1, 2024 ND: $0.00 (physician), effective Aug 1, 2026 NE: $21.82 (physician, non-facility), effective Jul 1, 2026 OH: $7.82 (physician), effective Jan 1, 2024 OK: $19.23 (physician, non-facility), effective Jul 1, 2026 VA: $16.62 (medical, facility), effective Jul 1, 2026 VT: $19.40 (outpatient_hospital_opps), effective Feb 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.