80412 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 80412

Payer coverage policies that name 80412

80412 appears in 3 coverage policies from Aetna, Blue Cross NC, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaInfertility (0327)covered if criteria are metJul 16, 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: $801.62 (lab), effective Oct 1, 2026
  • CO: $667.75 (lab_cdl), effective Jul 1, 2026
  • FL: $409.09 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $561.13 (practitioner), effective Apr 1, 2024
  • IN: $681.38 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2024
  • KS: $511.03 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $801.62 (lab), effective Jan 1, 2026
  • LA: $681.38 (lab_radiology), effective Jul 1, 2025
  • MS: $721.46 (comprehensive), effective Jul 1, 2026
  • ND: $801.62 (physician), effective Aug 1, 2026
  • NE: $801.62 (lab), effective Jul 1, 2026
  • OH: $601.22 (lab), effective Apr 1, 2019
  • OK: $713.03 (physician, non-facility), effective Jul 1, 2026
  • VA: $325.48 (medical), effective Jul 1, 2014
  • VT: $781.58 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $641.30 (physician, facility), 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.