87906 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 87906

Payer coverage policies that name 87906

87906 appears in 6 coverage policies from Aetna, Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaHIV Drug Susceptibility and Resistance Tests (0316)covered if criteria are metMay 21, 2026payer 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
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document
Premera Blue CrossHuman Immunodeficiency Virus (HIV)listed, no stanceFeb 6, 2026payer document

Medicaid fee-for-service

  • AZ: $128.73 (lab), effective Oct 1, 2026
  • CO: $128.73 (lab_cdl), effective Oct 1, 2025
  • FL: $87.86 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $108.68 (practitioner), effective Mar 1, 2013
  • IN: $109.42 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2020
  • KS: $96.55 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $128.73 (lab), effective Jan 1, 2026
  • LA: $128.73 (lab_radiology), effective Jan 1, 2020
  • MS: $115.86 (comprehensive), effective Jul 1, 2026
  • ND: $128.73 (physician), effective Aug 1, 2026
  • NE: $128.73 (lab), effective Jul 1, 2026
  • NY: $128.73 (lab), effective Aug 1, 2026
  • OH: $96.55 (lab), effective Apr 1, 2021
  • OK: $114.50 (physician, non-facility), effective Jul 1, 2026
  • VA: $128.73 (medical), effective Jan 1, 2020
  • VT: $125.51 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $102.98 (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.