Payer policies › CPT 8528085280 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 85280 Payer coverage policies that name 85280 85280 appears in 2 coverage policies from Blue Cross NC, Cigna.
Payer Policy Role in policy Reviewed Document Blue Cross NC Professional Pathology Billing Requirements AHS – R2169 listed, no stance (range 85210-85293) Mar 1, 2024 payer document Cigna Laboratory Testing Services (0604) not covered May 15, 2026 payer document
Medicaid fee-for-service AZ: $19.35 (lab), effective Oct 1, 2026 CO: $16.45 (lab_cdl), effective Apr 1, 2026 FL: $10.45 (lab_independent, non-facility), effective Jan 1, 2026 IL: $27.10 (practitioner), effective Apr 1, 2024 IN: $16.45 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020 KS: $12.34 (default, Exempt Physician), effective Jul 1, 2023 KY: $19.35 (lab), effective Jan 1, 2026 LA: $16.45 (lab_radiology), effective Jul 1, 2025 MS: $17.42 (comprehensive), effective Jul 1, 2026 ND: $19.35 (physician), effective Aug 1, 2026 NE: $19.35 (lab), effective Jul 1, 2026 NY: $19.35 (lab), effective Aug 1, 2026 OH: $14.51 (lab), effective Apr 1, 2021 OK: $17.21 (physician, non-facility), effective Jul 1, 2026 VA: $10.03 (medical), effective Jul 1, 2014 VT: $18.87 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $15.48 (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.