Payer policies › CPT 9947899478 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 99478 Payer coverage policies that name 99478 99478 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: $115.14 (physician, AHCCCS PT 08, facility), effective Oct 1, 2025 CO: $139.86 (chp_plus, non-facility), effective Jul 1, 2026 FL: $91.90 (physician, non-facility), effective Jan 1, 2026 IL: $90.16 (practitioner), effective Apr 1, 2024 IN: $103.11 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $92.53 (default, Exempt Physician), effective Aug 1, 2024 KY: $113.34 (physician, facility), effective Jan 1, 2026 LA: $114.88 (professional), effective Feb 1, 2013 MA: $97.92 (physician_medicine), effective May 1, 2024 MS: $111.87 (comprehensive, PCP), effective Jul 1, 2026 ND: $126.54 (physician), effective Aug 1, 2026 NE: $157.20 (physician, non-facility), effective Jul 1, 2026 NY: $71.18 (physician_medicine, facility), effective Jul 1, 2026 OH: $112.87 (physician), effective Jan 1, 2026 OK: $112.67 (physician, non-facility), effective Jul 1, 2026 TX: $141.36 (nurse_practitioner_clinical_nurse_specialist, Nurse Practitioner/Clinical Nurse Specialist, facility), effective Sep 1, 2023 VA: $83.51 (medical), effective Jul 1, 2026 VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $79.80 (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.