80061 CPT® code: payer coverage and prior authorization80061 appears in 17 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, BlueCross BlueShield of South Carolina, Centene, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Attention Deficit/Hyperactivity Disorder (0426) EEG theta/beta power ratio, Gut microbiota profile, polygenic risk score, evaluation of kynurenine pathway | not covered | Jul 7, 2026 | payer document |
| Aetna | Cardiac Computed Tomography (CT), Coronary CT Angiography, Calcium Scoring and CT Fractional Flow Reserve (0228) | listed, no stance | Jul 21, 2026 | payer document |
| Aetna | Cardiovascular Disease Risk Tests (0381) | listed, no stance | Aug 25, 2026 | payer document |
| Aetna | Erectile Dysfunction and Peyronie's Disease (0007) | covered if criteria are met | Jul 29, 2026 | payer document |
| Aetna | Inclisiran (Leqvio) (1004) | listed, no stance | Jul 14, 2026 | payer document |
| Aetna | Nonstandard Laboratory Test Panels (0499) | listed, no stance | Aug 3, 2026 | payer document |
| Aetna | Screening for Lipid Disorders (0525) | covered if criteria are met | Aug 18, 2026 | payer document |
| Anthem | Standard Lipid Panel Testing (CG-LAB-38) | covered if criteria are met | May 14, 2026 | payer document |
| Blue Cross & Blue Shield of Mississippi | Lipid Testing (L.2.04.411) | covered if criteria are met | payer document | |
| Blue Cross & Blue Shield of Mississippi | Pathogen Panel Testing (L.2.04.456) | not covered | payer document | |
| Blue Cross NC | Cardiovascular Disease Risk Assessment AHS – G2050 | listed, no stance | Apr 1, 2026 | payer document |
| Blue Cross NC | Professional Pathology Billing Requirements AHS – R2169 | listed, no stance (range 80047-80439) | Mar 1, 2024 | payer document |
| BlueCross BlueShield of South Carolina | Cardiovascular Disease Risk Assessment (CAM 188) | listed, no stance | Apr 1, 2026 | payer document |
| Centene | Attention Deficit Hyperactivity Disorder Assessment and Treatment (CP.MP.124) | not covered | Feb 1, 2022 | payer document |
| Centene | Attention Deficit Hyperactivity Disorder Assessment and Treatment (CP.BH.124) | not covered | Mar 1, 2024 | payer document |
| Health Care Service Corporation (BCBS IL, TX, OK, NM, MT) | Sexual Dysfunctions, Assessment and Treatment (MED201.030) CPT Codes 37788, 37790, 54110, 54111, 54112, 54200, 54205, 54230, 54231, | listed, no stance | Jan 1, 2026 | payer document |
| Premera Blue Cross | Preventive Care Dyslipidemia screening (Lipids) | covered if criteria are met | Sep 21, 2026 | payer document |
| Premera Blue Cross | Preventive Care Cholesterol screening | listed, no stance | Sep 21, 2026 | payer document |
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.