85018 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 85018

Payer coverage policies that name 85018

85018 appears in 13 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, BlueCross BlueShield of South Carolina, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaElivaldogene Autotemcel (Skysona) (1017)listed, no stanceApr 8, 2026payer document
AetnaFidanacogene Elaparvovec-dzkt (Beqvez) (1060)listed, no stanceApr 20, 2026payer document
AetnaHematopoietic Cell Transplantation for Aplastic Anemia and other Bone Marrow Failure Syndromes (0627)listed, no stance (range 85004-85049)Sep 23, 2026payer document
AetnaLysosomal Storage Disorder Treatments (0442)listed, no stanceJul 8, 2026payer document
AetnaNonstandard Laboratory Test Panels (0499)listed, no stanceAug 3, 2026payer document
AetnaSmell and Taste Disorders: Diagnosis (0390)covered if criteria are metMay 26, 2026payer document
AetnaTherapeutic Phlebotomy (0652)listed, no stanceSep 25, 2026payer document
Blue Cross & Blue Shield of MississippiComplete Blood Count Hemoglobin And Hematocrit (L.2.04.420)listed, no stancepayer document
Blue Cross NCPrenatal Screening (Nongenetic) AHS - G2035listed, no stanceOct 1, 2025payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 85002-85055)Mar 1, 2024payer document
BlueCross BlueShield of South CarolinaMaternity/Obstetrical Care Benefits (CAM 366)
85007 | BLOOD COUNT; BLOOD SMEAR, MICROSCOPIC EXAMINATION WITH MANUAL DIFFERENTIAL WBCCOUNT		listed, no stanceFeb 1, 2026payer document
BlueCross BlueShield of South CarolinaPrenatal Screening (Nongenetics) (CAM 119)
Number		listed, no stanceJul 1, 2026payer document
Premera Blue CrossPreventive Care
Procedure Code(s) | Comments		covered if criteria are metSep 21, 2026payer document

Medicaid fee-for-service

  • AZ: $2.37 (lab), effective Oct 1, 2026
  • CO: $2.37 (lab_cdl), effective Oct 1, 2025
  • FL: $1.28 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $4.64 (practitioner), effective Mar 1, 2013
  • IN: $2.01 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $1.51 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $2.37 (lab), effective Jan 1, 2026
  • LA: $2.36 (family_planning_clinic), effective Feb 1, 2013
  • MS: $2.13 (comprehensive), effective Jul 1, 2026
  • ND: $2.37 (physician), effective Aug 1, 2026
  • NE: $2.37 (lab), effective Jul 1, 2026
  • NY: $2.02 (lab), effective Aug 1, 2026
  • OH: $1.78 (lab), effective Jan 1, 2021
  • OK: $2.11 (physician, non-facility), effective Jul 1, 2026
  • TX: $2.20 (hhsc_family_planning_program, Hhsc Family Planning Program), effective Mar 1, 2021
  • VA: $0.96 (medical), effective Jul 1, 2014
  • VT: $2.31 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $1.90 (physician, facility), 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.