87501 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 87501

Payer coverage policies that name 87501

87501 appears in 11 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Blue Shield of California, BlueCross BlueShield of South Carolina, Cigna, Premera Blue Cross, Regence.

PayerPolicyRole in policyReviewedDocument
AetnaInfluenza Rapid Diagnostic Tests (0476)covered if criteria are metJul 24, 2026payer document
AetnaPolymerase Chain Reaction Testing: Selected Indications (0650)covered if criteria are metSep 10, 2026payer document
Blue Cross & Blue Shield of MississippiIdentification Of Microorganisms Using Nucleic Acid Probescovered if criteria are metpayer document
Blue Cross Blue Shield of MassachusettsIdentification of Microorganisms (555)listed, no stancepayer document
Blue Cross NCDiagnostic Testing of Influenza AHS - G2119listed, no stanceOct 1, 2025payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 87003-87999)Mar 1, 2024payer document
Blue Shield of CaliforniaIdentification of Microorganisms Using Nucleic Acid Probes (2.04.10)listed, no stancepayer document
BlueCross BlueShield of South CarolinaDiagnostic Testing of Influenza (CAM 134)listed, no stanceOct 1, 2025payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document
Premera Blue CrossDiagnostic Testing of Influenzalisted, no stanceOct 14, 2025payer document
RegenceIdentification of Microorganisms Using Nucleic Acid Probes (Genetic Testing 85)listed, no stanceDec 1, 2025payer document

Medicaid fee-for-service

  • AZ: $51.31 (lab), effective Oct 1, 2026
  • CO: $51.31 (lab_cdl), effective Oct 1, 2025
  • FL: $27.71 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $43.34 (practitioner), effective Jan 1, 2011
  • IN: $43.61 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $38.48 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $51.31 (lab), effective Jan 1, 2026
  • LA: $51.31 (lab_radiology), effective Jan 1, 2020
  • MS: $46.18 (comprehensive), effective Jul 1, 2026
  • ND: $51.31 (physician), effective Aug 1, 2026
  • NE: $51.31 (lab), effective Jul 1, 2026
  • NY: $51.31 (lab), effective Aug 1, 2026
  • OH: $38.48 (lab), effective Apr 1, 2021
  • OK: $45.64 (physician, non-facility), effective Jul 1, 2026
  • VA: $44.53 (medical), effective Jul 1, 2014
  • VT: $50.03 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $41.05 (physician, 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.