38308 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 38308

Payer coverage policies that name 38308

38308 appears in 3 coverage policies from Aetna, Blue Cross NC, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT).

PayerPolicyRole in policyReviewedDocument
AetnaLymphedema (0069)not coveredFeb 25, 2026payer document
Blue Cross NCSurgical Treatments for Lymphedemalisted, no stanceNov 1, 2025payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Surgical Treatments for Breast Cancer-Related Lymphedema (SUR701.024)
CPT Codes 15756, 15758, 15830, 15832, 15833, 15834, 15835, 15836, 15837,
listed, no stanceDec 15, 2025payer document

Medicaid fee-for-service

  • AZ: $995.48 (asc), effective Oct 1, 2026
  • CO: $370.83 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $348.09 (physician, non-facility), effective Jan 1, 2026
  • IL: $327.99 (practitioner), effective Apr 1, 2024
  • IN: $359.14 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $220.50 (asc, facility), effective Aug 1, 1982
  • KY: $1564.94 (asc), effective Jan 1, 2026
  • LA: $182.30 (asc), effective Jul 1, 2012
  • MA: $950.67 (asc), effective May 1, 2026
  • MS: $1230.44 (comprehensive, facility), effective Oct 1, 2025
  • ND: $922.54 (physician, facility), effective Aug 1, 2026
  • NE: $637.00 (asc), effective Jul 1, 2024
  • NY: $207.13 (physician_surgery, facility), effective Jul 1, 2026
  • OH: $246.21 (physician), effective Jan 1, 2024
  • OK: $1427.73 (asc), effective Jan 1, 2026
  • TX: $963.66 (ambulatory_surgical_center_asc_hospital_based_ambulatory_sur, Ambulatory Surgical Center (Asc) / Hospital - Based Ambulatory Surgical Center (Hasc)), effective Jun 1, 2023
  • VA: $387.73 (medical), effective Jul 1, 2026
  • VT: $3040.18 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $339.40 (asc), effective Jul 1, 2026
  • WY: $1731.55 (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.