Payer policies › CPT 8690086900 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 86900 Payer coverage policies that name 86900 86900 appears in 4 coverage policies from Blue Cross NC, BlueCross BlueShield of South Carolina.
Payer Policy Role in policy Reviewed Document Blue Cross NC Prenatal Screening (Nongenetic) AHS - G2035 listed, no stance Oct 1, 2025 payer document Blue Cross NC Professional Pathology Billing Requirements AHS – R2169 listed, no stance (range 86000-86999) Mar 1, 2024 payer document BlueCross BlueShield of South Carolina Maternity/Obstetrical Care Benefits (CAM 366)85049 | BLOOD COUNT; PLATELET, AUTOMATED listed, no stance Feb 1, 2026 payer document BlueCross BlueShield of South Carolina Prenatal Screening (Nongenetics) (CAM 119)Number listed, no stance Jul 1, 2026 payer document
Medicaid fee-for-service AZ: $2.99 (lab), effective Oct 1, 2026 CO: $2.99 (lab_cdl), effective Oct 1, 2025 FL: $1.61 (lab_independent, non-facility), effective Jan 1, 2026 IL: $2.99 (practitioner), effective Apr 1, 2024 IN: $2.54 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020 KS: $2.24 (default, Exempt Physician), effective Jul 1, 2023 KY: $2.99 (lab), effective Jan 1, 2026 LA: $2.98 (lab_radiology), effective Jul 1, 2012 MS: $101.04 (comprehensive), effective Jul 1, 2026 ND: $2.99 (physician), effective Aug 1, 2026 NE: $2.99 (lab), effective Jul 1, 2026 NY: $2.99 (lab), effective Aug 1, 2026 OH: $2.24 (lab), effective Apr 1, 2021 OK: $2.66 (physician, non-facility), effective Jul 1, 2026 TX: $2.78 (hhsc_family_planning_program, Hhsc Family Planning Program), effective Mar 1, 2021 VA: $2.99 (medical), effective Jan 1, 2020 VT: $103.31 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $2.39 (kidneycenters), effective Jul 1, 2026 WY: $58.84 (outpatient_hospital_apc, Ambulatory Surgical Centers), 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.