Payer policies › CPT 8308083080 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 83080 13 of 13 payer prior-auth lists that name 83080 require prior authorization or set conditions: CarePlus Health Plans, Humana.
Payer Plan State Prior auth Conditions Since Source CarePlus Health Plans CarePlus Health Plans FL prior auth required Jan 1, 2027 Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List Humana Humana D-SNP (FL) FL prior auth required Jan 1, 2027 1 *New prior authorization requirement 787403FL0725 FLHMQSREN Humana Dual Fully Integrated Florida Prior Authorization and Notification List Humana Humana D-SNP (IL) IL prior auth required Jan 1, 2027 Humana Dual Fully Integrated Illinois Prior Authorization and Notification List Humana Humana D-SNP (IN) IN prior auth required Jan 1, 2027 *New prior authorization requirement 814403IN0825 H4939_INHN6Z6EN_C Humana PathWays Dual Care (HMO-POS D-SNP) Indiana Prior Authorization and Notification List Humana Humana D-SNP (MI) MI prior auth required Jan 1, 2027 1 Humana Dual Highly Integrated Michigan Prior Authorization and Notification List Humana Humana D-SNP (SC) SC prior auth required Jan 1, 2027 Humana Dual Highly Integrated South Carolina Prior Authorization and Notification List Humana Humana D-SNP (VA) VA prior auth required Jan 1, 2027 Virginia Prior Authorization and Notification List Humana Humana Healthy Horizons IL prior auth required Jan 1, 2027 Humana Healthy Horizons in Illinois Prior Authorization and Notification List To view -specific medical coverage policies, please visit Humana Healthy Horizons in Illinois Clinical coverage policies . Humana Humana Healthy Horizons IN prior auth required Jan 1, 2027 1 Humana Healthy Horizons® in Indiana Preauthorization and Notification List (PAL) for Indiana PathWays for Aging Please note the term prior authorization when used in this communication, is defined a Humana Humana Healthy Horizons VA prior auth required Jan 1, 2027 Humana Healthy Horizons in Virginia Prior Authorization and Notification List (PAL) Humana Humana MA and D-SNP All prior auth required Jan 1, 2027 Medicare Advantage and Dual Eligible Special Needs Plans Prior Authorization and Notification List Humana Humana Puerto Rico MA and Dual Medicare-Medicaid PR prior auth required Nov 3, 2025 Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plans Preauthorization and Notification List Puerto Rico Medicare Advantage and Dual Medicare-Medicaid Plan Preauthorization and Notification Humana Oak Street Health All prior auth required Oak Street Health (Humana): Prior Authorization List (PAL) Codes Under Management
Payer coverage policies that name 83080 83080 appears in 3 coverage policies from Aetna, Blue Cross NC, Cigna.
Payer Policy Role in policy Reviewed Document Aetna Genetic Testing (0140)Genetic testing for dominant polycystic kidney disease (PKD1 and PKD2) covered if criteria are met Aug 18, 2026 payer document Blue Cross NC Professional Pathology Billing Requirements AHS – R2169 listed, no stance (range 83001-83993) Mar 1, 2024 payer document Cigna Laboratory Testing Services (0604) not covered May 15, 2026 payer document
Recent prior-auth changes Jan 1, 2027: PA added, Humana Jun 1, 2023: PA removed, Blue Shield of California Promise Health Plan Medicaid fee-for-service AZ: $16.87 (lab), effective Oct 1, 2026 CO: $16.87 (lab_cdl), effective Oct 1, 2025 FL: $5.38 (lab_independent, non-facility), effective Jan 1, 2026 IL: $23.62 (practitioner), effective Apr 1, 2024 IN: $14.34 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020 KY: $16.87 (lab), effective Jan 1, 2026 LA: $16.87 (lab_radiology), effective Jan 1, 2020 MS: $15.18 (comprehensive), effective Jul 1, 2026 ND: $16.87 (physician), effective Aug 1, 2026 NE: $16.87 (lab), effective Jul 1, 2026 NY: $16.87 (lab), effective Aug 1, 2026 OH: $12.65 (lab), effective Apr 1, 2021 OK: $15.01 (physician, non-facility), effective Jul 1, 2026 VA: $11.52 (medical), effective Jul 1, 2014 VT: $16.45 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $13.50 (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.