82163 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 82163

Payer coverage policies that name 82163

82163 appears in 4 coverage policies from Aetna, Blue Cross NC, Centene, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaCardiovascular Disease Risk Tests (0381)not coveredAug 25, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 82009-82958)Mar 1, 2024payer document
Centenecovered if criteria are metJan 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $20.52 (lab), effective Oct 1, 2026
  • CO: $20.52 (lab_cdl), effective Oct 1, 2025
  • FL: $12.13 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $14.36 (practitioner), effective Apr 1, 2024
  • IN: $17.44 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $12.60 (default, Exempt Physician), effective Jul 1, 1987
  • KY: $20.52 (lab), effective Jan 1, 2026
  • LA: $20.43 (lab_radiology), effective Jul 1, 2012
  • MS: $18.47 (comprehensive), effective Jul 1, 2026
  • ND: $20.52 (physician), effective Aug 1, 2026
  • NE: $20.52 (lab), effective Jul 1, 2026
  • OH: $15.39 (lab), effective Apr 1, 2021
  • OK: $18.25 (physician, non-facility), effective Jul 1, 2026
  • VA: $10.11 (medical), effective Jul 1, 2014
  • VT: $20.01 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $16.42 (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.