Does Humana require prior authorization for CPT 36466?

Yes. Humana requires prior authorization for CPT 36466 (Vein procedures for varicose veins and venous disease) under Standard commercial plans per its published clinical policy.

How much does Medicare pay for CPT 36466 in 2026?

In 2026, the national Medicare allowable for CPT 36466 is $1339.04 in an office setting and $133.27 in a facility. Commercial allowables for Humana are typically negotiated against this benchmark.

What if Humana denies the PA for CPT 36466?

Appeal in writing within 60 days, citing the specific clinical policy criteria the case meets and attaching supporting documentation. Many denials are reversed on first-level appeal when the criteria language is mirrored.

Prior Authorization

Humana Prior Authorization for CPT 36466

Vein procedures for varicose veins and venous disease · Standard commercial plans

Prior authorization REQUIREDLast updated March 18, 2026 · Reviewed by the D3rx Clinical Billing Team

Source

Data pending source-document linkage. Verify against Humana's current clinical policy before submission.

Not medical advice. PA policies change frequently. Always confirm against the payer's current policy before submitting. d3rx pulls directly from publicly published policy PDFs and refreshes daily.

Clinical criteria

Varicose vein - Surgical treatment and sclerotherapy

Documentation checklist

✓Clinical notes

2026 Medicare rate for CPT 36466

Office (non-facility)

$1339.04

Facility

$133.27

Total RVUs (office)

40.09

Conversion factor

$33.4009

National Medicare Physician Fee Schedule amounts (GPCI 1.0). Humana's commercial allowable is negotiated against this benchmark — see the full RVU and locality breakdown on the CPT 36466 code page.

How to submit the PA

1Verify the requirement against the current clinical policy linked above.
2Gather documentation: Clinical notes.
3Submit via the payer's provider portal or designated PA channel.
4Document the reference number and follow up within 5 business days if no determination is received.

FAQ

Does Humana require prior authorization for CPT 36466?: Yes. Humana requires prior authorization for CPT 36466 (Vein procedures for varicose veins and venous disease) under Standard commercial plans per its published clinical policy.
What documentation does Humana require for CPT 36466?: Clinical notes
How much does Medicare pay for CPT 36466 in 2026?: In 2026, the national Medicare allowable for CPT 36466 is $1339.04 in an office setting and $133.27 in a facility. Commercial allowables for Humana are typically negotiated against this benchmark.
What if Humana denies the PA for CPT 36466?: Appeal in writing within 60 days, citing the specific clinical policy criteria the case meets and attaching supporting documentation. Many denials are reversed on first-level appeal when the criteria language is mirrored.

Other Humana PA lookups

CPT 17110 CPT 45380 CPT 45378 CPT 11042 CPT 36415 CPT 20610 CPT 62323 CPT 43235

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CPT 36466 prior authorization by payer

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