Payer policies › CPT 9947299472 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 99472 Payer coverage policies that name 99472 99472 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: $347.21 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $408.43 (chp_plus, non-facility), effective Jul 1, 2026 FL: $269.94 (physician, non-facility), effective Jan 1, 2026 IL: $268.62 (practitioner), effective Apr 1, 2024 IN: $308.18 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $268.38 (default, Exempt Physician), effective Aug 1, 2024 KY: $313.91 (physician, facility), effective Jan 1, 2026 LA: $321.63 (professional), effective Jul 1, 2025 MA: $287.98 (physician_medicine), effective May 1, 2024 MS: $337.56 (comprehensive, PCP), effective Jul 1, 2026 ND: $382.63 (physician), effective Aug 1, 2026 NE: $428.85 (physician, non-facility), effective Jul 1, 2026 NY: $158.13 (physician_medicine, facility), effective Jul 1, 2026 OH: $331.79 (physician), effective Jan 1, 2026 OK: $340.39 (physician, non-facility), effective Jul 1, 2026 TX: $366.28 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2023 VA: $253.41 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $242.10 (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.