88187 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 88187

Payer coverage policies that name 88187

88187 appears in 14 coverage policies from Aetna, Blue Cross Blue Shield of Massachusetts, Blue Cross NC, Blue Shield of California, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross.

PayerPolicyRole in policyReviewedDocument
AetnaEculizumab (0807)listed, no stanceAug 11, 2026payer document
AetnaEtuvetidigene Autotemcel (Waskyra) (1097)listed, no stanceOct 5, 2026payer document
AetnaFlow Cytometry, Ektacytometry, DNA Ploidy, and S-phase Fraction (0351)covered if criteria are metMay 21, 2026payer document
AetnaInfertility (0327)not covered (range 88187-88189)Jul 16, 2026payer document
AetnaMarnetegragene Autotemcel (Kresladi) (1102)listed, no stance (range 88182-88189)Jul 13, 2026payer document
AetnaPreconceptional Sex Selection Techniques (0323)listed, no stanceMay 20, 2026payer document
AetnaTumor Markers (0352)covered if criteria are metAug 25, 2026payer document
Blue Cross Blue Shield of MassachusettsFlow Cytometry for Cell Analysis (341)listed, no stancepayer document
Blue Cross NCFlow Cytometry AHS - F2019listed, no stanceApr 1, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 88104-88199)Mar 1, 2024payer document
Blue Shield of CaliforniaSerum Biomarker Panel Testing for Systemic Lupus Erythematosus and Other Connective Tissue Diseases (2.04.123)listed, no stancepayer document
CignaFlow Cytometry (0538)covered if criteria are metSep 15, 2026payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Serum Panel Testing for Systemic Lupus Erythematosus and Other Connective Tissue Diseases (MED207.159)
CPT Codes 81599, 83520, 84999, 86038, 86039, 86146, 86147, 86200, 86225,
listed, no stanceOct 15, 2026payer document
Premera Blue CrossFlow Cytometrylisted, no stanceOct 14, 2025payer document

Medicaid fee-for-service

  • AZ: $169.70 (outpatient_hospital), effective Oct 1, 2014
  • CO: $36.10 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $24.73 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $33.95 (practitioner), effective Apr 1, 2024
  • IN: $28.10 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $25.06 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $52.09 (lab), effective Jan 1, 2026
  • LA: $35.26 (lab_radiology), effective Jan 1, 2022
  • MA: $25.88 (physician_surgery), effective May 1, 2024
  • MS: $30.08 (comprehensive), effective Jul 1, 2026
  • ND: $38.68 (physician), effective Aug 1, 2026
  • NE: $71.98 (physician, non-facility), effective Jul 1, 2026
  • NY: $20.20 (lab), effective Aug 1, 2026
  • OH: $26.46 (lab), effective Apr 1, 2025
  • OK: $31.62 (physician, non-facility), effective Jul 1, 2026
  • TX: $29.75 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), facility), effective Sep 1, 2025
  • VA: $30.38 (medical), effective Jul 1, 2026
  • VT: $29.27 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $20.83 (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.