85244 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 85244

Payer coverage policies that name 85244

85244 appears in 3 coverage policies from Aetna, Blue Cross NC, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaClotting Factors (0131)listed, no stanceApr 23, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 85210-85293)Mar 1, 2024payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $20.42 (lab), effective Oct 1, 2026
  • CO: $17.36 (lab_cdl), effective Apr 1, 2026
  • FL: $11.03 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $28.58 (practitioner), effective Apr 1, 2024
  • IN: $17.36 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $14.17 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $20.42 (lab), effective Jan 1, 2026
  • LA: $20.33 (lab_radiology), effective Jul 1, 2012
  • MS: $18.38 (comprehensive), effective Jul 1, 2026
  • ND: $20.42 (physician), effective Aug 1, 2026
  • NE: $20.42 (lab), effective Jul 1, 2026
  • NY: $9.49 (lab), effective Aug 1, 2026
  • OH: $15.31 (lab), effective Apr 1, 2021
  • OK: $18.16 (physician, non-facility), effective Jul 1, 2026
  • VA: $11.80 (medical), effective Jul 1, 2014
  • VT: $19.91 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $16.34 (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.