80069 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 80069

Payer coverage policies that name 80069

80069 appears in 8 coverage policies from Aetna, Blue Cross NC, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaAfamitresgene Autoleucel (Tecelra) (1068)listed, no stanceJan 14, 2026payer document
AetnaAtidarsagene Autotemcel (Lenmeldy) (1058)listed, no stanceJul 13, 2026payer document
AetnaLifileucel (Amtagvi) (1056)listed, no stanceApr 8, 2026payer document
AetnaMarnetegragene Autotemcel (Kresladi) (1102)listed, no stanceJul 13, 2026payer document
AetnaNedosiran (Rivfloza) (1047)listed, no stanceFeb 20, 2026payer document
AetnaPancreas Transplantation Alone (PTA) and Islet Cell Transplantation (0601)listed, no stanceSep 18, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 80047-80439)Mar 1, 2024payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $8.68 (lab), effective Oct 1, 2026
  • CO: $7.38 (lab_cdl), effective Apr 1, 2026
  • FL: $4.69 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $8.52 (practitioner), effective Jan 1, 2010
  • IN: $7.38 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $6.51 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $8.68 (lab), effective Jan 1, 2026
  • LA: $8.68 (lab_radiology), effective Jan 1, 2020
  • MS: $7.81 (comprehensive), effective Jul 1, 2026
  • ND: $8.68 (physician), effective Aug 1, 2026
  • NE: $8.68 (lab), effective Jul 1, 2026
  • NY: $8.68 (lab), effective Aug 1, 2026
  • OH: $6.51 (lab), effective Jan 1, 2021
  • OK: $7.72 (physician, non-facility), effective Jul 1, 2026
  • TX: $8.07 (hhsc_family_planning_program, Hhsc Family Planning Program), effective Mar 1, 2021
  • VA: $8.68 (medical), effective Jan 1, 2020
  • VT: $8.46 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $6.94 (kidneycenters), effective Jul 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.