84270 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 84270

Payer coverage policies that name 84270

84270 appears in 8 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Centene, Cigna, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaInfertility (0327)covered if criteria are metJul 16, 2026payer document
AetnaTestosterone Undecanoate (Aveed) Injection (0528)listed, no stanceJul 9, 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 84030-84999)Mar 1, 2024payer document
Blue Cross NCTestosterone AHS – G2013listed, no stanceJan 1, 2026payer document
Centenecovered if criteria are metJan 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document
Premera Blue CrossTestosteronelisted, no stanceMay 12, 2026payer document

Medicaid fee-for-service

  • AZ: $21.73 (lab), effective Oct 1, 2026
  • CO: $21.73 (lab_cdl), effective Oct 1, 2025
  • FL: $11.17 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $16.38 (practitioner), effective Oct 1, 2008
  • IN: $18.47 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $13.85 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $21.73 (lab), effective Jan 1, 2026
  • LA: $21.62 (lab_radiology), effective Jul 1, 2012
  • MS: $19.56 (comprehensive), effective Jul 1, 2026
  • ND: $21.73 (physician), effective Aug 1, 2026
  • NE: $21.73 (lab), effective Jul 1, 2026
  • OH: $16.30 (lab), effective Apr 1, 2021
  • OK: $19.33 (physician, non-facility), effective Jul 1, 2026
  • VA: $12.66 (medical), effective Jul 1, 2014
  • VT: $21.19 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $17.38 (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.