C9039 Injection, plazomicin

Payer policies and prior authorization for C9039

Payer coverage policies that name C9039

C9039 appears in 1 coverage policy from Aetna.

Medicaid fee-for-service

• WY: $0.00 (professional), effective Jan 1, 2020

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.