86663 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 86663

Payer coverage policies that name 86663

86663 appears in 4 coverage policies from Aetna, Blue Cross NC, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaMyalgic Encephalomyelitis - Chronic Fatigue Syndrome (ME/CSF) (0369)not coveredMay 20, 2026payer document
AetnaOral Screening and Lesion Identification Systems (0760)not covered (range 86663-86665)Dec 2, 2025payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 86000-86999)Mar 1, 2024payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $13.12 (lab), effective Oct 1, 2026
  • CO: $13.12 (lab_cdl), effective Oct 1, 2025
  • FL: $7.08 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $12.77 (practitioner), effective Apr 1, 2024
  • IN: $11.15 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $8.36 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $13.12 (lab), effective Jan 1, 2026
  • LA: $13.05 (lab_radiology), effective Jul 1, 2012
  • MS: $11.81 (comprehensive), effective Jul 1, 2026
  • ND: $13.12 (physician), effective Aug 1, 2026
  • NE: $13.12 (lab), effective Jul 1, 2026
  • NY: $13.12 (lab), effective Aug 1, 2026
  • OH: $9.84 (lab), effective Apr 1, 2021
  • OK: $11.67 (physician, non-facility), effective Jul 1, 2026
  • VA: $13.12 (medical), effective Jan 1, 2020
  • VT: $12.79 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $10.50 (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.