84550 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 84550

Payer coverage policies that name 84550

84550 appears in 8 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaFetal Fibronectin, Inflammatory Biomarkers, and Salivary Hormone Testing for Preterm Labor (0166)not coveredApr 21, 2026payer document
AetnaGout (0810)covered if criteria are metMar 27, 2026payer document
AetnaNonstandard Laboratory Test Panels (0499)listed, no stanceAug 3, 2026payer document
AetnaRosacea (0547)not coveredAug 21, 2026payer document
AetnaWeight Reduction Programs and Devices (0039)listed, no stanceMar 10, 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
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $4.52 (lab), effective Oct 1, 2026
  • CO: $3.77 (lab_cdl), effective Jul 1, 2026
  • FL: $2.44 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $4.42 (podiatrist), effective Apr 1, 2024
  • IN: $3.84 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $3.39 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $4.52 (lab), effective Jan 1, 2026
  • LA: $4.49 (lab_radiology), effective Jul 1, 2012
  • MS: $4.07 (comprehensive), effective Jul 1, 2026
  • ND: $4.52 (physician), effective Aug 1, 2026
  • NE: $4.52 (lab), effective Jul 1, 2026
  • NY: $4.52 (lab), effective Aug 1, 2026
  • OH: $3.39 (lab), effective Jan 1, 2021
  • OK: $4.02 (physician, non-facility), effective Jul 1, 2026
  • VA: $4.52 (medical), effective Jan 1, 2020
  • VT: $4.41 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $3.62 (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.