82172 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 82172

Payer coverage policies that name 82172

82172 appears in 13 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Blue Shield of California, BlueCross BlueShield of South Carolina, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaAlzheimer's Disease Tests (0349)not coveredAug 4, 2026payer document
AetnaCardiovascular Disease Risk Tests (0381)covered if criteria are metAug 25, 2026payer document
AetnaInclisiran (Leqvio) (1004)listed, no stanceJul 14, 2026payer document
AetnaNonstandard Laboratory Test Panels (0499)listed, no stanceAug 3, 2026payer document
AetnaObstructive Sleep Apnea in Adults (0004)not coveredOct 6, 2026payer document
AetnaParkinson's Disease (0307)not coveredFeb 24, 2026payer document
Blue Cross & Blue Shield of MississippiBiomarker Testing In Risk Assessment And Management Of Cardiovascular Diseaseunproven / investigationalpayer document
Blue Cross Blue Shield of MassachusettsNovel Biomarkers in Risk Assessment and Management of Cardiovascular Disease (283)unproven / investigationalpayer document
Blue Cross NCCardiovascular Disease Risk Assessment AHS – G2050listed, no stanceApr 1, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 82009-82958)Mar 1, 2024payer document
Blue Shield of CaliforniaBiomarker Testing in Risk Assessment and Management of Cardiovascular Disease (2.04.65)listed, no stancepayer document
BlueCross BlueShield of South CarolinaCardiovascular Disease Risk Assessment (CAM 188)listed, no stanceApr 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $21.09 (lab), effective Oct 1, 2026
  • CO: $17.57 (lab_cdl), effective Jul 1, 2026
  • FL: $11.38 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $44.28 (practitioner), effective Apr 1, 2024
  • IN: $17.93 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2024
  • KY: $21.09 (lab), effective Jan 1, 2026
  • MS: $18.98 (comprehensive), effective Jul 1, 2026
  • ND: $21.09 (physician), effective Aug 1, 2026
  • NE: $21.09 (lab), effective Jul 1, 2026
  • NY: $16.09 (lab), effective Aug 1, 2026
  • OH: $15.82 (lab), effective Apr 1, 2019
  • OK: $18.76 (physician, non-facility), effective Jul 1, 2026
  • VA: $10.62 (medical), effective Jul 1, 2014
  • VT: $0.00 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $16.87 (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.