Payer policies › CPT 9946999469 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 99469 Payer coverage policies that name 99469 99469 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 AZ: $335.01 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $397.68 (chp_plus, non-facility), effective Jul 1, 2026 FL: $261.62 (physician, non-facility), effective Jan 1, 2026 IL: $261.27 (practitioner), effective Apr 1, 2024 IN: $299.89 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $268.35 (default, Exempt Physician), effective Aug 1, 2024 KY: $308.57 (physician, facility), effective Jan 1, 2026 LA: $333.00 (professional), effective May 1, 2021 MA: $284.11 (physician_medicine), effective May 1, 2024 MS: $325.02 (comprehensive, PCP), effective Jul 1, 2026 ND: $367.61 (physician), effective Aug 1, 2026 NE: $419.01 (physician, non-facility), effective Jul 1, 2026 NY: $156.57 (physician_medicine, facility), effective Jul 1, 2026 OH: $321.85 (physician), effective Jan 1, 2026 OK: $327.35 (physician, non-facility), effective Jul 1, 2026 TX: $368.31 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2023 VA: $242.58 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $231.56 (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.