76830 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 76830

Payer coverage policies that name 76830

76830 appears in 10 coverage policies from Aetna, Anthem, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Cigna, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaInfertility (0327)covered if criteria are metJul 16, 2026payer document
AetnaPrenatal Care Provided by Primary Care Physicians (0047)listed, no stanceOct 6, 2026payer document
AetnaTransvaginal Ultrasonography (0530)covered if criteria are metAug 20, 2026payer document
AetnaUltrasound for Pregnancy (0199)listed, no stanceMar 24, 2026payer document
AnthemNon-Obstetrical Transvaginal Ultrasonography (CG-RAD-30)covered if criteria are metAug 13, 2026payer document
Blue Cross Blue Shield of MassachusettsObstetrical Ultrasound (007)listed, no stancepayer document
Blue Cross NCInfertility Diagnosis and Treatment – B0006listed, no stanceMar 1, 2026payer document
CignaInfertility Services (0089)covered if criteria are metJun 15, 2025payer document
CignaTransvaginal Ultrasound, Non-Obstetrical (0398)not coveredMar 15, 2026payer document
UnitedHealthcareInfertility Diagnosis, Treatment, and Fertility Preservation (2026T0270NN)listed, no stanceJun 1, 2026payer document

Medicaid fee-for-service

  • AZ: $31.31 (asc), effective Oct 1, 2026
  • CO: $99.02 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $24.42 (radiology), effective Jan 1, 2026
  • IL: $76.76 (practitioner), effective Apr 1, 2024
  • IN: $90.36 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $51.25 (default, Exempt Physician), effective Jan 1, 2024
  • KY: $55.68 (asc), effective Jan 1, 2026
  • LA: $91.71 (lab_radiology), effective Jul 1, 2025
  • MA: $70.11 (physician_radiology), effective May 1, 2024
  • MS: $45.37 (comprehensive, facility), effective Oct 1, 2025
  • ND: $130.67 (physician), effective Aug 1, 2026
  • NE: $86.52 (physician, non-facility), effective Jul 1, 2026
  • NY: $60.60 (ordered_ambulatory), effective Jul 24, 2026
  • OH: $71.50 (physician), effective Jan 1, 2024
  • OK: $71.14 (physician, non-facility), effective Jul 1, 2026
  • TX: $23.86 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), facility), effective Mar 1, 2025
  • VA: $32.89 (medical), effective Jul 1, 2026
  • VT: $81.18 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $72.81 (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.