82550 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 82550

Payer coverage policies that name 82550

82550 appears in 8 coverage policies from Aetna, Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaHypoxic Ischemic Encephalopathy (0812)not coveredNov 20, 2025payer document
AetnaNonstandard Laboratory Test Panels (0499)listed, no stanceAug 3, 2026payer document
Blue Cross NCBiomarkers for Myocardial Infarction and Chronic Heart Failure AHS - G2150listed, no stanceJul 1, 2025payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 82009-82958)Mar 1, 2024payer document
BlueCross BlueShield of South CarolinaBiomarkers for Myocardial Infarction and Chronic Heart Failure (CAM 193)listed, no stanceJul 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Sexual Dysfunctions, Assessment and Treatment (MED201.030)
CPT Codes 37788, 37790, 54110, 54111, 54112, 54200, 54205, 54230, 54231,		listed, no stanceJan 1, 2026payer document
Premera Blue CrossBiomarkers for Myocardial Infarction and Chronic Heart Failurelisted, no stanceOct 14, 2025payer document

Medicaid fee-for-service

  • AZ: $6.51 (lab), effective Oct 1, 2026
  • CO: $6.51 (lab_cdl), effective Oct 1, 2025
  • FL: $3.52 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $18.24 (practitioner), effective Mar 1, 2013
  • IN: $5.53 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $4.88 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $6.51 (lab), effective Jan 1, 2026
  • LA: $6.48 (lab_radiology), effective Jul 1, 2012
  • MS: $5.86 (comprehensive), effective Jul 1, 2026
  • ND: $6.51 (physician), effective Aug 1, 2026
  • NE: $6.51 (lab), effective Jul 1, 2026
  • NY: $5.08 (lab), effective Aug 1, 2026
  • OH: $4.88 (lab), effective Jan 1, 2021
  • OK: $5.79 (physician, non-facility), effective Jul 1, 2026
  • VA: $6.51 (medical), effective Jan 1, 2020
  • VT: $6.35 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $5.21 (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.