82247 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 82247

Payer coverage policies that name 82247

82247 appears in 9 coverage policies from Aetna, Blue Cross NC.

PayerPolicyRole in policyReviewedDocument
AetnaElivaldogene Autotemcel (Skysona) (1017)listed, no stanceApr 8, 2026payer document
AetnaEtranacogene Dezaparvovec-drlb (Hemgenix) (1023)listed, no stanceApr 17, 2026payer document
AetnaFidanacogene Elaparvovec-dzkt (Beqvez) (1060)listed, no stanceApr 20, 2026payer document
AetnaMarnetegragene Autotemcel (Kresladi) (1102)listed, no stance (range 82247-82252)Jul 13, 2026payer document
AetnaNeonatal Hyperbilirubinemia (0332)covered if criteria are metJun 2, 2026payer document
AetnaRosacea (0547)not coveredAug 21, 2026payer document
AetnaSutimlimab-jome (Enjaymo) (1006)listed, no stanceDec 3, 2025payer document
AetnaValoctocogene Roxaparvovec-rvox (Roctavian) (1037)listed, no stanceApr 20, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 82009-82958)Mar 1, 2024payer document

Medicaid fee-for-service

  • AZ: $5.02 (lab), effective Oct 1, 2026
  • CO: $4.27 (lab_cdl), effective Apr 1, 2026
  • FL: $2.71 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $4.66 (practitioner), effective Mar 1, 2013
  • IN: $4.27 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $3.76 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $5.02 (lab), effective Jan 1, 2026
  • LA: $4.27 (lab_radiology), effective Jul 1, 2025
  • MS: $4.52 (comprehensive), effective Jul 1, 2026
  • ND: $5.02 (physician), effective Aug 1, 2026
  • NE: $5.02 (lab), effective Jul 1, 2026
  • NY: $5.02 (lab), effective Aug 1, 2026
  • OH: $3.77 (lab), effective Apr 1, 2021
  • OK: $4.47 (physician, non-facility), effective Jul 1, 2026
  • VA: $5.02 (medical), effective Jan 1, 2020
  • VT: $4.89 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $4.02 (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.