99476 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 99476

Payer coverage policies that name 99476

99476 appears in 1 coverage policy from Blue Cross NC.

PayerPolicyRole in policyReviewedDocument
Blue Cross NCEvaluation and Management Serviceslisted, no stance (range 99202-99499)Jun 1, 2026payer document

Medicaid fee-for-service

  • AZ: $294.84 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025
  • CO: $273.71 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $238.21 (physician, non-facility), effective Jan 1, 2026
  • IL: $227.63 (practitioner), effective Apr 1, 2024
  • IN: $262.53 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $222.02 (default, Exempt Physician), effective Aug 1, 2024
  • KY: $261.99 (physician, facility), effective Jan 1, 2026
  • LA: $272.36 (professional), effective Jul 1, 2025
  • MA: $246.71 (physician_medicine), effective May 1, 2024
  • MS: $292.52 (comprehensive, PCP), effective Jul 1, 2026
  • ND: $331.93 (physician), effective Aug 1, 2026
  • NE: $265.06 (physician, non-facility), effective Jul 1, 2026
  • NY: $163.70 (physician_medicine, facility), effective Jul 1, 2026
  • OH: $277.27 (physician), effective Jan 1, 2026
  • OK: $295.51 (physician, non-facility), effective Jul 1, 2026
  • TX: $246.62 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2023
  • VA: $220.68 (medical), effective Jul 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $210.71 (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.