C9507 Covid-19 convalescent plasma

Plasma, high titer covid-19 convalescent, each unit

Medically Unlikely Edits (effective October 1, 2026)

Payer policies and prior authorization for C9507

Medicaid fee-for-service

  • AZ: $529.11 (outpatient_hospital), effective Oct 1, 2023
  • IN: $637.92 (professional, Advanced Practice Nurse (85%), non-facility), effective Apr 1, 2022
  • MS: $505.47 (comprehensive), effective Jul 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VA: $750.50 (medical), effective Dec 28, 2021
  • VT: $516.82 (outpatient_hospital_opps), effective Feb 1, 2026
  • WY: $294.36 (outpatient_hospital_apc, Ambulatory Surgical Centers), 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.