Payer policies › CPT 8504585045 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 85045 Payer coverage policies that name 85045 85045 appears in 4 coverage policies from Aetna, Blue Cross NC, Cigna.
Payer Policy Role in policy Reviewed Document Aetna Hematopoietic Cell Transplantation for Aplastic Anemia and other Bone Marrow Failure Syndromes (0627) listed, no stance (range 85004-85049) Sep 23, 2026 payer document Aetna Sutimlimab-jome (Enjaymo) (1006) listed, no stance Dec 3, 2025 payer document Blue Cross NC Professional Pathology Billing Requirements AHS – R2169 listed, no stance (range 85002-85055) Mar 1, 2024 payer document Cigna Laboratory Testing Services (0604) not covered May 15, 2026 payer document
Medicaid fee-for-service AZ: $3.99 (lab), effective Oct 1, 2026 CO: $3.99 (lab_cdl), effective Oct 1, 2025 FL: $2.15 (lab_independent, non-facility), effective Jan 1, 2026 IL: $2.79 (practitioner), effective Apr 1, 2024 IN: $3.39 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020 KS: $2.99 (default, Exempt Physician), effective Jul 1, 2023 KY: $3.99 (lab), effective Jan 1, 2026 LA: $3.99 (lab_radiology), effective Jul 1, 2012 MS: $3.59 (comprehensive), effective Jul 1, 2026 ND: $3.99 (physician), effective Aug 1, 2026 NE: $3.99 (lab), effective Jul 1, 2026 NY: $3.20 (lab), effective Aug 1, 2026 OH: $2.99 (lab), effective Jan 1, 2021 OK: $3.55 (physician, non-facility), effective Jul 1, 2026 TX: $3.71 (hhsc_family_planning_program, Hhsc Family Planning Program), effective Oct 27, 2023 VA: $2.51 (medical), effective Jul 1, 2014 VT: $3.89 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $3.19 (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.