Payer policies › CPT 7682876828 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 76828 Payer coverage policies that name 76828 76828 appears in 5 coverage policies from Aetna, Blue Cross NC, BlueCross BlueShield of South Carolina.
Payer Policy Role in policy Reviewed Document Aetna Color-Flow Doppler Echocardiography and Myocardial Strain Imaging (0008) listed, no stance Mar 10, 2026 payer document Aetna Fetal Echocardiography and Magnetocardiography (0106) covered if criteria are met Mar 26, 2026 payer document Aetna Prenatal Care Provided by Primary Care Physicians (0047) listed, no stance Oct 6, 2026 payer document Blue Cross NC Maternal and Fetal Diagnostics listed, no stance Mar 1, 2026 payer document BlueCross BlueShield of South Carolina Maternity/Obstetrical Care Benefits (CAM 366)59020 | FETAL CONTRACTION STRESS TEST listed, no stance Feb 1, 2026 payer document
Medicaid fee-for-service AZ: $79.00 (outpatient_hospital), effective Oct 1, 2021 CO: $25.52 (chp_plus, non-facility), effective Jul 1, 2026 FL: $16.61 (radiology), effective Jan 1, 2026 IL: $71.90 (practitioner), effective Aug 1, 2019 IN: $20.85 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $13.43 (default, Exempt Physician), effective Jan 1, 2024 KY: $0.00 (asc), effective Jan 1, 2026 LA: $43.14 (lab_radiology), effective Jul 1, 2012 MA: $18.41 (physician_radiology), effective May 1, 2024 MS: $79.39 (comprehensive), effective Jul 1, 2026 ND: $25.16 (physician), effective Aug 1, 2026 NE: $47.59 (physician, non-facility), effective Jul 1, 2026 NY: $25.25 (ordered_ambulatory), effective Jul 24, 2026 OH: $38.82 (physician), effective Jan 1, 2024 OK: $24.11 (physician, non-facility), effective Jul 1, 2026 TX: $21.10 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), facility), effective Sep 1, 2025 VA: $27.13 (medical), effective Jul 1, 2026 VT: $81.18 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $15.86 (physician, facility), effective Jul 1, 2026 WY: $46.23 (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.