Q2009 Fosphenytoin inj pe

Injection, fosphenytoin, 50 mg phenytoin equivalent

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for Q2009

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for Q2009

1 of 2 payer prior-auth lists that name Q2009 require prior authorization or set conditions: Rocky Mountain Health Plans.

PayerPlanStatePrior authConditionsSinceSource
Rocky Mountain Health PlansRocky Mountain Medicare Advantage D-SNPCOprior auth requiredFeb 1, 2025Rocky Mountain Health Plans Medicare Advantage Dual-Special Needs Plans – prior authorization Effective February 1, 2025

Payer coverage policies that name Q2009

Q2009 appears in 4 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaEagle's and Ernest Syndrome (0400)listed, no stanceJun 30, 2026payer document
AetnaEpilepsy Surgery (0394)listed, no stanceJun 23, 2026payer document
AetnaInjectable Medications (0020)listed, no stance (range Q2009-Q2017)Mar 5, 2026payer document
AetnaVasectomy Procedures and Chronic Scrotal Content Pain (0027)listed, no stanceJan 27, 2026payer document

Recent prior-auth changes

  • Apr 1, 2025: PA removed, UnitedHealthcare
  • Mar 1, 2025: PA added, UnitedHealthcare
  • Jan 1, 2025: PA removed, UnitedHealthcare

Medicaid fee-for-service

  • AZ: $1.27 (asc), effective Oct 1, 2026
  • IL: $0.86 (practitioner), effective Apr 1, 2026
  • IN: $0.44 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2024
  • KS: $2.46 (asc, facility), effective Oct 1, 2024
  • KY: $1.34 (asc), effective Jan 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • OH: $1.41 (provider_administered_drugs), effective Apr 1, 2014
  • VA: $0.45 (medical), effective Apr 1, 2010
  • VT: $1.12 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $1.69 (professional_administered_drugs), effective Jul 1, 2026
  • WY: $0.58 (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.