84145 CPT® code: payer coverage and prior authorization10 of 13 payer prior-auth lists that name 84145 require prior authorization or set conditions: Molina Healthcare of California, Molina Healthcare of Florida, Molina Healthcare of Idaho, Molina Healthcare of Michigan, Molina Healthcare of New Mexico, Molina Healthcare of Ohio, Molina Healthcare of South Carolina, Molina Healthcare of Utah, Molina Healthcare of Washington, Molina Healthcare, Inc. (national grid).
| Payer | Plan | State | Prior auth | Conditions | Since | Source |
|---|---|---|---|---|---|---|
| Molina Healthcare of California | Medicare Advantage | CA | prior auth required | Jul 1, 2021 | Medicare Prior Auth (PA) Code Matrix (California), effective Q3 2021 | |
| Molina Healthcare of Florida | Medicare Advantage | FL | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Florida), effective Q2 2021 | |
| Molina Healthcare of Idaho | Medicare Advantage | ID | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Idaho), effective Q2 2021 | |
| Molina Healthcare of Michigan | Exchange | MI | prior auth required | Jul 1, 2021 | Molina Healthcare of Michigan PA Matrix, effective 7/1/2021 | |
| Molina Healthcare of New Mexico | Medicare Advantage | NM | prior auth required | Jan 1, 2021 | Medicare Prior Auth (PA) Code Matrix (New Mexico), effective Q1 2021 | |
| Molina Healthcare of Ohio | Medicare and MyCare Ohio (MMP) Medicare | OH | prior auth required | Oct 1, 2023 | Molina Healthcare of Ohio Prior Authorization (PA) Code List, effective 2023-10-01 | |
| Molina Healthcare of South Carolina | Medicare Advantage | SC | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (South Carolina), effective Q2 2021 | |
| Molina Healthcare of Utah | Medicare Advantage | UT | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Utah), effective Q2 2021 | |
| Molina Healthcare of Washington | Medicare Advantage | WA | prior auth required | Apr 1, 2021 | Medicare Prior Auth (PA) Code Matrix (Washington), effective Q2 2021 | |
| Molina Healthcare, Inc. (national grid) | Molina national (MHI) Medicare grid | All | prior auth required | Oct 1, 2021 | Medicare Prior Auth (PA) Code Matrix (national), effective Q4 2021 |
84145 appears in 8 coverage policies from Aetna, Blue Cross NC, Cigna, Premera Blue Cross.
| Payer | Policy | Role in policy | Reviewed | Document |
|---|---|---|---|---|
| Aetna | Fetal Fibronectin, Inflammatory Biomarkers, and Salivary Hormone Testing for Preterm Labor (0166) | not covered | Apr 21, 2026 | payer document |
| Aetna | Inflammatory Disease: Biomarker and Thiopurine Pharmacogenomic Testing (0249) | not covered | Apr 27, 2026 | payer document |
| Aetna | Liver Transplantation (0596) | not covered | Sep 8, 2026 | payer document |
| Aetna | Procalcitonin (PCT) (0771) | covered if criteria are met | Nov 13, 2025 | payer document |
| Blue Cross NC | Pancreatic Enzyme Testing for Acute Pancreatitis AHS – G2153 | listed, no stance | Apr 1, 2026 | payer document |
| Blue Cross NC | Professional Pathology Billing Requirements AHS – R2169 | listed, no stance (range 84030-84999) | Mar 1, 2024 | payer document |
| Cigna | Laboratory Testing Services (0604) | not covered | May 15, 2026 | payer document |
| Premera Blue Cross | Pancreatic Enzyme Testing for Acute Pancreatitis | listed, no stance | Oct 14, 2025 | payer document |
Prior authorization required or conditional in MS.
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.