86701 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 86701

Payer coverage policies that name 86701

86701 appears in 8 coverage policies from Aetna, Blue Cross NC, BlueCross BlueShield of South Carolina, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaElivaldogene Autotemcel (Skysona) (1017)listed, no stanceApr 8, 2026payer document
AetnaHIV Testing (0542)covered if criteria are metAug 28, 2026payer document
AetnaInfertility (0327)covered if criteria are metJul 16, 2026payer document
AetnaMarnetegragene Autotemcel (Kresladi) (1102)listed, no stanceJul 13, 2026payer document
Blue Cross NCHuman Immunodeficiency Virus AHS – M2116listed, no stanceApr 1, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 86000-86999)Mar 1, 2024payer document
BlueCross BlueShield of South CarolinaHuman Immunodeficiency Virus Testing (CAM 282)listed, no stanceApr 1, 2026payer document
Premera Blue CrossPreventive Care
HIV screening
covered if criteria are metSep 21, 2026payer document

Medicaid fee-for-service

  • AZ: $8.89 (lab), effective Oct 1, 2026
  • CO: $7.56 (lab_cdl), effective Apr 1, 2026
  • FL: $4.81 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $17.78 (practitioner), effective Apr 1, 2024
  • IN: $7.56 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $5.67 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $8.89 (lab), effective Jan 1, 2026
  • LA: $8.84 (lab_radiology), effective Jul 1, 2012
  • MS: $8.00 (comprehensive), effective Jul 1, 2026
  • ND: $8.89 (physician), effective Aug 1, 2026
  • NE: $8.89 (lab), effective Jul 1, 2026
  • NY: $8.89 (lab), effective Aug 1, 2026
  • OH: $6.67 (lab), effective Jan 1, 2021
  • OK: $7.91 (physician, non-facility), effective Jul 1, 2026
  • TX: $8.27 (hhsc_family_planning_program, Hhsc Family Planning Program), effective Mar 1, 2021
  • VA: $5.04 (medical), effective Jul 1, 2014
  • VT: $8.67 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $7.11 (family_planning, facility), 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.