88358 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 88358

Payer coverage policies that name 88358

88358 appears in 5 coverage policies from Aetna, Blue Cross NC, BlueCross BlueShield of South Carolina.

PayerPolicyRole in policyReviewedDocument
AetnaTumor Chemoresistance Assays (0758)not coveredDec 2, 2025payer document
AetnaTumor Chemosensitivity Assays (0245)not coveredApr 13, 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 88300-88399)Mar 1, 2024payer document
BlueCross BlueShield of South CarolinaLaboratory/Pathology Services (CAM 472)listed, no stanceJan 1, 2026payer document

Medicaid fee-for-service

  • AZ: $108.14 (outpatient_hospital), effective Oct 1, 2021
  • CO: $45.61 (chp_plus, non-facility), effective Jul 1, 2026
  • IL: $105.67 (practitioner), effective Mar 1, 2013
  • IN: $66.05 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $51.64 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $115.41 (lab), effective Jan 1, 2026
  • LA: $105.49 (lab_radiology), effective Jul 1, 2025
  • MA: $36.25 (physician_surgery), effective May 1, 2024
  • MS: $129.38 (comprehensive), effective Jul 1, 2026
  • ND: $145.69 (physician), effective Aug 1, 2026
  • NE: $80.23 (physician, non-facility), effective Jul 1, 2026
  • OH: $61.56 (lab), effective Apr 1, 2025
  • OK: $70.34 (physician, non-facility), effective Jul 1, 2026
  • TX: $104.32 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), non-facility), effective Sep 1, 2025
  • VA: $112.85 (medical), effective Jul 1, 2026
  • VT: $132.29 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $53.13 (kidneycenters), effective Jul 1, 2026
  • WY: $75.35 (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.