85044 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 85044

Payer coverage policies that name 85044

85044 appears in 4 coverage policies from Aetna, Blue Cross NC, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaHematopoietic Cell Transplantation for Aplastic Anemia and other Bone Marrow Failure Syndromes (0627)listed, no stance (range 85004-85049)Sep 23, 2026payer document
AetnaSutimlimab-jome (Enjaymo) (1006)listed, no stanceDec 3, 2025payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 85002-85055)Mar 1, 2024payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $4.31 (lab), effective Oct 1, 2026
  • CO: $4.31 (lab_cdl), effective Oct 1, 2025
  • FL: $2.33 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $3.50 (practitioner), effective Feb 1, 2013
  • IN: $3.66 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $3.23 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $4.31 (lab), effective Jan 1, 2026
  • LA: $4.28 (lab_radiology), effective Jul 1, 2012
  • MS: $3.88 (comprehensive), effective Jul 1, 2026
  • ND: $4.31 (physician), effective Aug 1, 2026
  • NE: $4.31 (lab), effective Jul 1, 2026
  • NY: $1.44 (lab), effective Aug 1, 2026
  • OH: $3.23 (lab), effective Jan 1, 2021
  • OK: $3.83 (physician, non-facility), effective Jul 1, 2026
  • TX: $4.01 (hhsc_family_planning_program, Hhsc Family Planning Program), effective Oct 27, 2023
  • VA: $4.31 (medical), effective Jan 1, 2020
  • VT: $4.20 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $3.45 (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.