87535 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 87535

Payer coverage policies that name 87535

87535 appears in 10 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross Blue Shield of Massachusetts, 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
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 Rhode IslandSexually Transmitted Infections Testing — Professionallisted, no stancepayer document
Blue Cross Blue Shield of MassachusettsIdentification of Microorganisms (555)listed, no stancepayer document
Blue Cross NCHuman Immunodeficiency Virus AHS – M2116listed, no stanceApr 1, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 87003-87999)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: $35.09 (lab), effective Oct 1, 2026
  • CO: $35.09 (lab_cdl), effective Oct 1, 2025
  • FL: $18.94 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $35.09 (practitioner), effective Apr 1, 2024
  • IN: $29.83 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $22.37 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $35.09 (lab), effective Jan 1, 2026
  • LA: $35.09 (lab_radiology), effective Jan 1, 2020
  • MS: $31.58 (comprehensive), effective Jul 1, 2026
  • ND: $35.09 (physician), effective Aug 1, 2026
  • NE: $35.09 (lab), effective Jul 1, 2026
  • NY: $21.64 (lab), effective Aug 1, 2026
  • OH: $26.32 (lab), effective Apr 1, 2021
  • OK: $31.21 (physician, non-facility), effective Jul 1, 2026
  • TX: $32.63 (hhsc_family_planning_program, Hhsc Family Planning Program), effective Mar 1, 2021
  • VA: $35.09 (medical), effective Jan 1, 2020
  • VT: $34.21 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $28.07 (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.