80417 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 80417

Payer coverage policies that name 80417

80417 appears in 3 coverage policies from Aetna, Blue Cross NC, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaAutomated Ambulatory Blood Pressure Monitoring (0025)listed, no stanceMar 12, 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: $43.99 (lab), effective Oct 1, 2026
  • CO: $36.64 (lab_cdl), effective Jul 1, 2026
  • FL: $29.92 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $43.08 (practitioner), effective Jan 1, 2010
  • IN: $37.39 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KY: $43.99 (lab), effective Jan 1, 2026
  • LA: $43.76 (lab_radiology), effective Jul 1, 2012
  • MS: $39.59 (comprehensive), effective Jul 1, 2026
  • ND: $43.99 (physician), effective Aug 1, 2026
  • NE: $43.99 (lab), effective Jul 1, 2026
  • OH: $32.99 (lab), effective Jan 1, 2021
  • OK: $39.13 (physician, non-facility), effective Jul 1, 2026
  • VA: $43.99 (medical), effective Jan 1, 2020
  • VT: $42.89 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $35.19 (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.