Payer policies › CPT 8830488304 CPT® code: payer coverage and prior authorizationPayer policies and prior authorization for 88304 Payer coverage policies that name 88304 88304 appears in 4 coverage policies from Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna, UnitedHealthcare.
Payer Policy Role in policy Reviewed Document Blue Cross NC Professional Pathology Billing Requirements AHS – R2169 listed, no stance (range 88300-88399) Mar 1, 2024 payer document Blue Cross NC Professional Pathology Billing Requirements AHS – R2169 listed, no stance (range 88300-88309) Mar 1, 2024 payer document BlueCross BlueShield of South Carolina Laboratory/Pathology Services (CAM 472) listed, no stance Jan 1, 2026 payer document Cigna Laboratory Testing Services (0604) not covered May 15, 2026 payer document UnitedHealthcare Preventive Care Services (MP.016.59)Procedure Code(s): | Age Limits: 45 to 75 years (ends on listed, no stance Jul 1, 2026 payer document
Medicaid fee-for-service AZ: $36.08 (outpatient_hospital), effective Oct 1, 2021 CO: $43.64 (chp_plus, non-facility), effective Jul 1, 2026 FL: $28.97 (lab_independent, non-facility), effective Jan 1, 2026 IL: $37.35 (practitioner), effective Jul 1, 2026 IN: $8.72 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026 KS: $6.76 (default, Exempt Physician), effective Jul 1, 2023 KY: $8.30 (lab), effective Jan 1, 2026 LA: $37.56 (lab_radiology), effective Jan 1, 2019 MA: $8.27 (physician_surgery), effective May 1, 2024 MS: $39.57 (comprehensive), effective Jul 1, 2026 ND: $45.81 (physician), effective Aug 1, 2026 NE: $11.67 (physician, non-facility), effective Jul 1, 2026 NY: $25.58 (lab), effective Aug 1, 2026 OH: $22.42 (lab), effective Apr 1, 2025 OK: $25.66 (physician, non-facility), effective Jul 1, 2026 TX: $8.11 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), facility), effective Sep 1, 2021 VA: $8.97 (medical), effective Jul 1, 2026 VT: $40.46 (outpatient_hospital_opps), effective Feb 1, 2026 WA: $6.12 (kidneycenters), effective Jul 1, 2026 WY: $23.05 (outpatient_hospital_apc, Ambulatory Surgical Centers), 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.