C9815 Peristlc pmp nonopioid dev

Linear peristaltic pain management infusion pump (e.g. cadd-solis ambulatory infusion pump), and all disposable system components, non-opioid medical device (must be a qualifying medicare non-opioid medical device for post-surgical pain relief in accordance with section 4135 of the caa, 2023)

Payer policies and prior authorization for C9815

Payer coverage policies that name C9815

C9815 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaAnesthetic and Antiemetic Infusion Pumps (0607)not coveredSep 9, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • ND: $0.00 (physician), effective Aug 1, 2026
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 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.