G0492 Md/oth eval acut kid no esrd

Dialysis procedure with single evaluation by a physician or other qualified health care professional for acute kidney injury without esrd

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for G0492

Physician Fee Schedule (CY 2026, RVU26D)

Status X: statutory exclusion, not paid under the PFS.

Payer policies and prior authorization for G0492

Payer coverage policies that name G0492

G0492 appears in 1 coverage policy from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaDialysis (0541)listed, no stanceAug 26, 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
  • 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.