87802 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 87802

Payer coverage policies that name 87802

87802 appears in 5 coverage policies from Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna.

PayerPolicyRole in policyReviewedDocument
Blue Cross NCPrenatal Screening (Nongenetic) AHS - G2035listed, 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 CarolinaMaternity/Obstetrical Care Benefits (CAM 366)
85049 | BLOOD COUNT; PLATELET, AUTOMATED		listed, no stanceFeb 1, 2026payer document
BlueCross BlueShield of South CarolinaPrenatal Screening (Nongenetics) (CAM 119)
Number		listed, no stanceJul 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $12.73 (lab), effective Oct 1, 2026
  • CO: $10.82 (lab_cdl), effective Apr 1, 2026
  • FL: $6.88 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $12.73 (practitioner), effective Apr 1, 2024
  • IN: $10.82 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $8.12 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $12.73 (lab), effective Jan 1, 2026
  • LA: $12.73 (lab_radiology), effective Jan 1, 2020
  • MS: $11.46 (comprehensive), effective Jul 1, 2026
  • ND: $12.73 (physician), effective Aug 1, 2026
  • NE: $12.73 (lab), effective Jul 1, 2026
  • OH: $9.55 (lab), effective Apr 1, 2025
  • OK: $11.32 (physician, non-facility), effective Jul 1, 2026
  • VA: $12.73 (medical), effective Jan 1, 2020
  • VT: $12.41 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $10.18 (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.