83003 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 83003

1 of 1 payer prior-auth lists that name 83003 require prior authorization or set conditions: UnitedHealthcare Community Plan.

PayerPlanStatePrior authConditionsSinceSource
UnitedHealthcare Community PlanMaryland HealthChoiceMDprior auth under conditionsonly with dx F64.0, F64.1, F64.2, F64.8, F64.9, Z87.890Sep 1, 2026Prior authorization requirements for UnitedHealthcare Community Plan of Maryland Effective September 1, 2026

Payer coverage policies that name 83003

83003 appears in 5 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Centene, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaGrowth Hormone (GH) and Growth Hormone Antagonists (0170)listed, no stanceJun 26, 2026payer document
Blue Cross & Blue Shield of MississippiPathogen Panel Testing (L.2.04.456)not coveredpayer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 83001-83993)Mar 1, 2024payer document
Centenecovered if criteria are metJan 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Recent prior-auth changes

  • Jun 1, 2023: PA removed, Blue Shield of California Promise Health Plan

Medicaid fee-for-service

  • AZ: $16.67 (lab), effective Oct 1, 2026
  • CO: $14.17 (lab_cdl), effective Apr 1, 2026
  • FL: $9.00 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $58.35 (practitioner), effective Apr 1, 2024
  • IN: $14.17 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $12.50 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $16.67 (lab), effective Jan 1, 2026
  • LA: $16.59 (lab_radiology), effective Jul 1, 2012
  • MS: $15.00 (comprehensive), effective Jul 1, 2026
  • ND: $16.67 (physician), effective Aug 1, 2026
  • NE: $16.67 (lab), effective Jul 1, 2026
  • NY: $16.67 (lab), effective Aug 1, 2026
  • OH: $12.50 (lab), effective Apr 1, 2021
  • OK: $14.83 (physician, non-facility), effective Jul 1, 2026
  • VA: $16.67 (medical), effective Jan 1, 2020
  • VT: $16.25 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $13.34 (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.