85048 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 85048

Payer coverage policies that name 85048

85048 appears in 9 coverage policies from Aetna, Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaBenralizumab (Fasenra) (0925)listed, no stanceAug 25, 2026payer document
AetnaElivaldogene Autotemcel (Skysona) (1017)listed, no stanceApr 8, 2026payer document
AetnaGenetic Testing (0140)listed, no stanceAug 18, 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
AetnaSmell and Taste Disorders: Diagnosis (0390)covered if criteria are metMay 26, 2026payer 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)
85032 | BLOOD COUNT; MANUAL CELL COUNT (ERYTHROCYTE, LEUKOCYTE OR PLATELET) EACH		listed, no stanceFeb 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $2.54 (lab), effective Oct 1, 2026
  • CO: $2.16 (lab_cdl), effective Apr 1, 2026
  • FL: $1.37 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $1.73 (practitioner), effective Apr 1, 2024
  • IN: $2.16 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $1.62 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $2.54 (lab), effective Jan 1, 2026
  • LA: $2.53 (lab_radiology), effective Jul 1, 2012
  • MS: $2.29 (comprehensive), effective Jul 1, 2026
  • ND: $2.54 (physician), effective Aug 1, 2026
  • NE: $2.54 (lab), effective Jul 1, 2026
  • NY: $2.54 (lab), effective Aug 1, 2026
  • OH: $1.91 (lab), effective Jan 1, 2021
  • OK: $2.26 (physician, non-facility), effective Jul 1, 2026
  • TX: $2.36 (hhsc_family_planning_program, Hhsc Family Planning Program), effective Oct 27, 2023
  • VA: $1.09 (medical), effective Jul 1, 2014
  • VT: $2.48 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $2.03 (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.