80076 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 80076

Payer coverage policies that name 80076

80076 appears in 13 coverage policies from Aetna, Blue Cross NC, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaAtidarsagene Autotemcel (Lenmeldy) (1058)listed, no stanceJul 13, 2026payer document
AetnaEating Disorders (0511)covered if criteria are metAug 4, 2026payer document
AetnaErectile Dysfunction and Peyronie's Disease (0007)covered if criteria are metJul 29, 2026payer document
AetnaEtranacogene Dezaparvovec-drlb (Hemgenix) (1023)listed, no stanceApr 17, 2026payer document
AetnaLysosomal Storage Disorder Treatments (0442)listed, no stanceJul 8, 2026payer document
AetnaMarnetegragene Autotemcel (Kresladi) (1102)listed, no stanceJul 13, 2026payer document
AetnaMyalgic Encephalomyelitis - Chronic Fatigue Syndrome (ME/CSF) (0369)covered if criteria are metMay 20, 2026payer document
AetnaOnasemnogene Abeparvovec (Zolgensma and Itvisma) (0953)listed, no stanceAug 10, 2026payer document
AetnaRemdesivir (Veklury) (0982)listed, no stanceJan 13, 2026payer document
AetnaTeplizumab-mzwv (Tzield) (1022)listed, no stanceDec 3, 2025payer document
AetnaWeight Reduction Programs and Devices (0039)listed, no stanceMar 10, 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: $8.17 (lab), effective Oct 1, 2026
  • CO: $6.94 (lab_cdl), effective Apr 1, 2026
  • FL: $4.41 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $7.98 (practitioner), effective Jan 1, 2010
  • IN: $6.94 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $6.13 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $8.17 (lab), effective Jan 1, 2026
  • LA: $8.17 (lab_radiology), effective Jan 1, 2020
  • MS: $7.35 (comprehensive), effective Jul 1, 2026
  • ND: $8.17 (physician), effective Aug 1, 2026
  • NE: $8.17 (lab), effective Jul 1, 2026
  • NY: $7.32 (lab), effective Aug 1, 2026
  • OH: $6.13 (lab), effective Jan 1, 2021
  • OK: $7.27 (physician, non-facility), effective Jul 1, 2026
  • TX: $7.60 (hhsc_family_planning_program, Hhsc Family Planning Program), effective Mar 1, 2021
  • VA: $8.17 (medical), effective Jan 1, 2020
  • VT: $7.97 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $6.54 (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.