0434U CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 0434U

Payer coverage policies that name 0434U

0434U appears in 16 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna, Regence, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaPharmacogenetic and Pharmacodynamic Testing (0715)not coveredOct 8, 2026payer document
Blue Cross & Blue Shield of MississippiCytochrome P450 Genotypeguided Treatment Strategyunproven / investigationalpayer document
Blue Cross NCPharmacogenetics Testing AHS - M2021listed, no stanceApr 1, 2026payer document
BlueCross BlueShield of South CarolinaPharmacogenetic Testing (CAM 218)
Genes		listed, no stanceApr 1, 2026payer document
CignaPharmacogenetic Testing (0500)not coveredJul 15, 2026payer document
RegenceCytochrome p450 and VKORC1 Genotyping for Treatment Selection and Dosing (Genetic Testing 10)listed, no stanceJun 1, 2026payer document
RegenceGenetic Testing for Diagnosis and Management of Behavioral Health Conditions (Genetic Testing 53)listed, no stanceJun 1, 2026payer document
UnitedHealthcarePharmacogenetic Panel Testing (2026T0587Y)listed, no stanceJul 1, 2026payer document
UnitedHealthcarePharmacogenetic Panel Testing (CS149.Z)listed, no stanceAug 1, 2026payer document
UnitedHealthcarePharmacogenetic Panel Testing (for Idaho Only) (CS149ID.C)listed, no stanceJun 1, 2026payer document
UnitedHealthcarePharmacogenetic Panel Testing (for Kansas Only) (CS149KS.03)listed, no stanceAug 1, 2026payer document
UnitedHealthcarePharmacogenetic Panel Testing (for Nebraska Only) (CS149NE.H)listed, no stanceJan 1, 2026payer document
UnitedHealthcarePharmacogenetic Panel Testing (for New Mexico Only) (CS149NM.G)listed, no stanceAug 1, 2026payer document
UnitedHealthcarePharmacogenetic Panel Testing (for Ohio Only) (CS149OH.F)listed, no stanceFeb 1, 2026payer document
UnitedHealthcarePharmacogenetic Panel Testing (for Pennsylvania Only) (CS149PA.T)listed, no stanceJan 1, 2026payer document
UnitedHealthcarePharmacogenetic Panel Testing (for Tennessee Only) (CS149TN.X)listed, no stanceAug 1, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN, MS.

  • FL: $225.06 (lab_independent, non-facility), effective Jan 1, 2026
  • KY: $416.78 (lab), effective Jan 1, 2026
  • MS: $375.10 (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.