83020 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 83020

Payer coverage policies that name 83020

83020 appears in 6 coverage policies from Aetna, Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna, Premera Blue Cross, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaGenetic Testing (0140)listed, no stanceAug 18, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 83001-83993)Mar 1, 2024payer document
BlueCross BlueShield of South CarolinaLaboratory/Pathology Services (CAM 472)listed, no stanceJan 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document
Premera Blue CrossPreventive Care
Hemoglobinopathies (Sickle cell screening)
covered if criteria are metSep 21, 2026payer document
UnitedHealthcarePreventive Care Services (MP.016.59)
Panel (Newborns) | Metabolic Screening Panel: | Ages 0 to 90 days. Does not have
listed, no stanceJul 1, 2026payer document

Medicaid fee-for-service

  • AZ: $12.87 (lab), effective Oct 1, 2026
  • CO: $14.28 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $6.95 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $23.45 (practitioner), effective Apr 1, 2024
  • IN: $14.11 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $10.85 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $12.87 (lab), effective Jan 1, 2026
  • LA: $12.82 (lab_radiology), effective Jul 1, 2012
  • MA: $13.01 (physician_surgery), effective May 1, 2024
  • MS: $15.18 (comprehensive), effective Jul 1, 2026
  • ND: $19.53 (physician), effective Aug 1, 2026
  • NE: $12.87 (lab), effective Jul 1, 2026
  • NY: $12.87 (lab), effective Aug 1, 2026
  • OH: $9.65 (lab), effective Apr 1, 2021
  • OK: $11.45 (physician, non-facility), effective Jul 1, 2026
  • TX: $11.97 (hhsc_family_planning_program, Hhsc Family Planning Program), effective Mar 1, 2021
  • VA: $15.34 (medical), effective Jul 1, 2026
  • VT: $12.55 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $10.51 (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.