Payer policies › CPT 8536685366 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 85366 Payer coverage policies that name 85366 85366 appears in 3 coverage policies from Aetna, Blue Cross NC, Cigna.
Payer Policy Role in policy Reviewed Document Aetna Tumor Markers (0352) covered if criteria are met (range 85362-85380) Aug 25, 2026 payer document Blue Cross NC Professional Pathology Billing Requirements AHS – R2169 listed, no stance (range 85300-85397) Mar 1, 2024 payer document Cigna Laboratory Testing Services (0604) not covered May 15, 2026 payer document
Medicaid fee-for-service AZ: $80.46 (lab), effective Oct 1, 2026 CO: $80.46 (lab_cdl), effective Oct 1, 2025 FL: $9.59 (lab_independent, non-facility), effective Jan 1, 2026 IL: $56.32 (practitioner), effective Apr 1, 2024 IN: $68.39 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2024 KS: $7.65 (default, Exempt Physician), effective Apr 1, 1993 KY: $80.46 (lab), effective Jan 1, 2026 LA: $68.39 (lab_radiology), effective Jul 1, 2025 MS: $72.41 (comprehensive), effective Jul 1, 2026 ND: $80.46 (physician), effective Aug 1, 2026 NE: $80.46 (lab), effective Jul 1, 2026 NY: $7.66 (lab), effective Aug 1, 2026 OH: $60.35 (lab), effective Apr 1, 2019 OK: $71.57 (physician, non-facility), effective Jul 1, 2026 VA: $2.63 (medical), effective Jul 1, 2014 VT: $78.45 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $64.37 (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.