82166 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 82166

Payer coverage policies that name 82166

82166 appears in 5 coverage policies from Aetna, Blue Cross NC, Centene, 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 82009-82958)Mar 1, 2024payer document
Centenecovered if criteria are metJan 1, 2026payer document
CignaInfertility Services (0089)covered if criteria are metJun 15, 2025payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

Prior authorization required or conditional in IN, VA.

  • AZ: $38.62 (lab), effective Oct 1, 2026
  • CO: $31.51 (lab_cdl), effective Oct 1, 2025
  • IL: $27.81 (practitioner), effective Jan 1, 2024
  • KY: $38.62 (lab), effective Jan 1, 2026
  • LA: $32.83 (lab_radiology), effective Jul 1, 2025
  • MS: $34.76 (comprehensive), effective Jul 1, 2026
  • ND: $38.62 (physician), effective Aug 1, 2026
  • NY: $23.23 (lab), effective Aug 1, 2026
  • OH: $28.97 (lab), effective Jul 1, 2024
  • VA: $33.99 (medical), effective Jan 1, 2024
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $30.90 (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.