`0107U` CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0107U

Payer coverage policies that name 0107U

0107U appears in 2 coverage policies from Capital Blue Cross, Cigna.

Payer	Policy	Role in policy	Reviewed	Document
Capital Blue Cross	Experimental and Investigational Procedures (MP 4.002) Procedure codes: Lab services	listed, no stance	Sep 1, 2026	payer document
Cigna	Laboratory Testing Services (0604)	not covered	May 15, 2026	payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN, MS.

FL: $8.64 (lab_independent, non-facility), effective Jan 1, 2026
KY: $16.00 (lab), effective Jan 1, 2026
MS: $14.40 (comprehensive), effective Jul 1, 2026
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.

0107U CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0107U

Payer coverage policies that name 0107U

Medicaid fee-for-service

`0107U` CPT® code: payer coverage and prior authorization