87661 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 87661

Payer coverage policies that name 87661

87661 appears in 9 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, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaDiagnosis of Vaginitis (0643)covered if criteria are metSep 25, 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 MississippiPathogen Panel Testing (L.2.04.456)not coveredpayer 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 NCDiagnostic Testing of Sexually Transmitted Infections AHS – G2157listed, no stanceApr 1, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 87003-87999)Mar 1, 2024payer document
CignaNucleic Acid Pathogen Testing (0530)covered if criteria are metAug 15, 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: $28.72 (practitioner), effective Jan 1, 2014
  • IN: $29.83 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $26.32 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $35.09 (lab), effective Jan 1, 2026
  • LA: $34.33 (lab_radiology), effective Jan 1, 2014
  • 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 (physician, facility), effective Jul 1, 2026
  • WY: $31.58 (professional), effective Sep 1, 2025

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.