88166 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 88166

Payer coverage policies that name 88166

88166 appears in 9 coverage policies from Aetna, Anthem, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, BlueCross BlueShield of South Carolina, Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaCervical Cancer Screening and Diagnosis (0443)covered if criteria are metJul 22, 2026payer document
AetnaDiagnosis of Vaginitis (0643)
uBiome SmartJane screen
not covered (range 88164-88167)Sep 25, 2026payer document
AetnaEndometrial Cancer Screening, Diagnosis, and Prognosis (0769)listed, no stance (range 88141-88175)Oct 3, 2025payer document
AetnaKidney Transplantation (0493)listed, no stance (range 88141-88175)Jul 30, 2026payer document
AnthemCervical Cancer Screening Using Cytology and Human Papillomavirus Detection (CG-MED-53)covered if criteria are metFeb 19, 2026payer document
Blue Cross & Blue Shield of MississippiCervical Cancer Screening Technologies With Pap And Hpv (L.2.04.421)covered if criteria are metpayer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 88104-88199)Mar 1, 2024payer document
BlueCross BlueShield of South CarolinaCervical Cancer Screening Technologies With Pap and HPV (CAM 314)listed, no stanceOct 1, 2025payer document
Premera Blue CrossPreventive Care
Cervical cancer screening (PAP smear) Includes patient navigation and consult
covered if criteria are metSep 21, 2026payer document

Medicaid fee-for-service

  • AZ: $18.54 (lab), effective Oct 1, 2026
  • CO: $16.23 (lab_cdl), effective Oct 1, 2025
  • FL: $9.59 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $12.43 (practitioner), effective Apr 1, 2024
  • IN: $15.46 (professional, Advanced Practice Nurse (85%), non-facility), effective Jan 1, 2026
  • KS: $12.41 (default), effective Feb 1, 2001
  • KY: $18.54 (lab), effective Jan 1, 2026
  • LA: $15.10 (lab_radiology), effective Jul 1, 2025
  • MS: $16.69 (comprehensive), effective Jul 1, 2026
  • ND: $18.54 (physician), effective Aug 1, 2026
  • NE: $18.54 (lab), effective Jul 1, 2026
  • OH: $13.91 (lab), effective Apr 1, 2026
  • OK: $16.49 (physician, non-facility), effective Jul 1, 2026
  • VA: $5.98 (medical), effective Jul 1, 2014
  • VT: $17.74 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $14.83 (family_planning, 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.