87637 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 87637

Payer coverage policies that name 87637

87637 appears in 11 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross & Blue Shield of Rhode Island, Blue Cross NC, 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
AnthemRespiratory Virus Testing for SARS-CoV-2, Influenza and RSV in the Outpatient Setting (CG-LAB-39)
Multiplex molecular tests
covered if criteria are metAug 13, 2026payer document
Blue Cross & Blue Shield of MississippiCoronavirus Disease 2019 Covid19 Reverse Transcriptionpolymerase Chain Reaction Rtpcr Testing (L.5.01.545)covered if criteria are metpayer document
Blue Cross & Blue Shield of Rhode IslandMedicare Advantage Plans Laboratory Network Hospital Outpatient Allowable Test Listing
COVID-19
listed, no stanceNov 5, 2025payer document
Blue Cross NCPathogen Panel Testing AHS – G2149listed, no stanceOct 1, 2025payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 87003-87999)Mar 1, 2024payer document
BlueCross BlueShield of South CarolinaPathogen Panel Testing (CAM 181)listed, no stanceJul 1, 2026payer document
CignaNucleic Acid Pathogen Testing (0530)covered if criteria are metAug 15, 2026payer document
Premera Blue CrossPathogen Panel Testinglisted, no stanceJun 17, 2026payer document
RegenceCOVID-19 Testing (Laboratory 74)listed, no stanceJun 1, 2026payer document

Medicaid fee-for-service

  • AZ: $142.63 (lab), effective Oct 1, 2026
  • CO: $118.81 (lab_cdl), effective Jul 1, 2026
  • FL: $77.02 (lab_independent, non-facility), effective Jan 1, 2026
  • IN: $121.24 (professional, Advanced Practice Nurse (85%), non-facility), effective Apr 9, 2021
  • KS: $90.93 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $142.63 (lab), effective Jan 1, 2026
  • LA: $121.24 (lab_radiology), effective Jul 1, 2025
  • MS: $128.37 (comprehensive), effective Jul 1, 2026
  • ND: $142.63 (physician), effective Aug 1, 2026
  • NE: $142.63 (lab), effective Jul 1, 2026
  • NY: $85.59 (lab), effective Aug 1, 2026
  • OH: $106.97 (lab), effective Apr 1, 2025
  • OK: $126.87 (physician, non-facility), effective Jul 1, 2026
  • TX: $132.65 (hhsc_family_planning_program, Hhsc Family Planning Program), effective Sep 1, 2024
  • VA: $125.51 (medical), effective Oct 6, 2020
  • VT: $139.06 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $114.10 (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.