88305 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 88305

Payer coverage policies that name 88305

88305 appears in 24 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, Blue Shield of California, BlueCross BlueShield of South Carolina, Cigna, Health Care Service Corporation (BCBS IL, TX, OK, NM, MT), Premera Blue Cross, UnitedHealthcare.

PayerPolicyRole in policyReviewedDocument
AetnaAnthrax (0483)covered if criteria are metJul 29, 2026payer document
AetnaEndometrial Cancer Screening, Diagnosis, and Prognosis (0769)listed, no stance (range 88305-88309)Oct 3, 2025payer document
AetnaNerve Fiber Density Measurement (0774)listed, no stanceDec 11, 2025payer document
AetnaTumor Chemoresistance Assays (0758)not coveredDec 2, 2025payer document
AetnaTumor Chemosensitivity Assays (0245)not coveredApr 13, 2026payer document
AetnaTumor Markers (0352)listed, no stanceAug 25, 2026payer document
Blue Cross & Blue Shield of MississippiAdjunctive Techniques For Screening Surveillance And Risk Classification Of Barrett Esophagus And Esophageal Dysplasia (A.7.01.167)unproven / investigationalpayer document
Blue Cross & Blue Shield of MississippiSystems Pathology In Prostate Cancer (L.2.04.429)unproven / investigationalpayer document
Blue Cross NCCeliac Disease Testing AHS - G2043listed, no stanceOct 1, 2025payer document
Blue Cross NCHelicobacter Pylori Testing AHS – G2044listed, no stanceApr 1, 2026payer document
Blue Cross NCIn Vitro Chemoresistance and Chemosensitivity Assays AHS- G2100listed, no stanceNov 1, 2025payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 88300-88309)Mar 1, 2024payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 88300-88399)Mar 1, 2024payer document
Blue Cross NCProstate Biopsy Specimen Analysis AHS – G2007listed, no stanceNov 1, 2025payer document
Blue Shield of CaliforniaAdjunctive Techniques for Screening, Surveillance, and Risk Classification of Barrett Esophagus and Esophageal Dysplasia (7.01.167)listed, no stancepayer document
Blue Shield of California| Nerve Fiber Density Measurement (2.04.58)listed, no stancepayer document
BlueCross BlueShield of South CarolinaCeliac Disease Testing (CAM 315)listed, no stanceOct 1, 2025payer document
BlueCross BlueShield of South CarolinaLaboratory/Pathology Services (CAM 472)listed, no stanceJan 1, 2026payer document
BlueCross BlueShield of South CarolinaProstate Biopsy Specimen Analysis (CAM 331)
Code Number
listed, no stanceOct 1, 2025payer document
CignaInfertility Services (0089)unproven / investigationalJun 15, 2025payer document
CignaWide-Area Transepithelial Tissue Sampling with Computer-Assisted 3D Analysis (WATS3D) (0578)unproven / investigationalDec 15, 2025payer document
Health Care Service Corporation (BCBS IL, TX, OK, NM, MT)Reproductive Techniques and Immunotherapy for Recurrent Fetal Loss (OB402.023)
CPT Codes 55899, 58322, 58340, 58999, 76831, 82397, 83519, 83520, 86148, 86357,
listed, no stanceJan 1, 2026payer document
Premera Blue CrossAdjunctive Techniques for Screening, Surveillance, and Risk Classification of Barrett Esophagus and Esophageal Dysplasia (7.01.596)listed, no stanceJan 26, 2026payer document
Premera Blue CrossPreventive Care
Colonoscopy Pathology
covered if criteria are metSep 21, 2026payer document
UnitedHealthcarePreventive Care Services (MP.016.59)
Procedure Code(s): | Age Limits: 45 to 75 years (ends on
listed, no stanceJul 1, 2026payer document

Medicaid fee-for-service

  • AZ: $36.08 (outpatient_hospital), effective Oct 1, 2021
  • CO: $64.78 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $49.46 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $45.41 (practitioner), effective Apr 1, 2024
  • IN: $27.00 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $49.10 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $61.81 (lab), effective Jan 1, 2026
  • LA: $65.03 (lab_radiology), effective Jan 1, 2018
  • MA: $54.92 (physician_surgery), effective May 1, 2024
  • MS: $27.14 (comprehensive), effective Jul 1, 2026
  • ND: $78.48 (physician), effective Aug 1, 2026
  • NE: $110.75 (physician, non-facility), effective Jul 1, 2026
  • NY: $43.62 (lab), effective Aug 1, 2026
  • OH: $26.88 (lab), effective Apr 1, 2025
  • OK: $61.02 (physician, non-facility), effective Jul 1, 2026
  • TX: $26.56 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), facility), effective Sep 1, 2021
  • VA: $30.38 (medical), effective Jul 1, 2026
  • VT: $40.46 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $43.00 (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.