Q9964 Hocm>= 400mg/ml iodine, 1ml

High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml

Medically Unlikely Edits (effective October 1, 2026)

Medicare pricing for Q9964

Physician Fee Schedule (CY 2026, RVU26D)

Status E: excluded from the PFS by regulation.

Payer policies and prior authorization for Q9964

Payer coverage policies that name Q9964

Q9964 appears in 3 coverage policies from Aetna.

PayerPolicyRole in policyReviewedDocument
AetnaBack Pain - Invasive Procedures (0016)listed, no stance (range Q9958-Q9967)Oct 6, 2026payer document
AetnaDiscography (0733)listed, no stance (range Q9958-Q9967)Jun 17, 2025payer document
AetnaPositron Emission Tomography (PET) (0071)listed, no stance (range Q9958-Q9967)Sep 14, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN.

  • CO: $0.37 (health_first_colorado), effective Jul 1, 2026
  • KY: $0.00 (asc), effective Jan 1, 2026
  • ND: $0.00 (physician), effective Aug 1, 2026
  • VA: $0.29 (medical), effective Oct 1, 2008
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $0.29 (professional_administered_drugs), effective Jul 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.