88367 CPT® code: payer coverage and prior authorization

Payer policies and prior authorization for 88367

Payer coverage policies that name 88367

88367 appears in 11 coverage policies from Aetna, Blue Cross & Blue Shield of Mississippi, Blue Cross NC, BlueCross BlueShield of South Carolina, Cigna.

PayerPolicyRole in policyReviewedDocument
AetnaCervical Cancer Screening and Diagnosis (0443)not covered (range 88367-88377)Jul 22, 2026payer document
AetnaTrastuzumab Products (0313)listed, no stance (range 88367-88377)Jun 8, 2026payer document
AetnaTumor Markers (0352)listed, no stance (range 88367-88377)Aug 25, 2026payer document
Blue Cross & Blue Shield of MississippiUrinary Biomarkers For Cancer Screening Diagnosis And Surveillanceunproven / investigationalpayer document
Blue Cross NCEsophageal Pathology Testing AHS - M2171listed, no stanceApr 1, 2026payer document
Blue Cross NCMolecular Diagnostics for Breast Cancer Prognosis AHS - M2020listed, no stanceApr 1, 2026payer document
Blue Cross NCProfessional Pathology Billing Requirements AHS – R2169listed, no stance (range 88300-88399)Mar 1, 2024payer document
BlueCross BlueShield of South CarolinaEsophageal Pathology Testing (CAM 242)
Number
listed, no stanceApr 1, 2026payer document
BlueCross BlueShield of South CarolinaLaboratory/Pathology Services (CAM 472)listed, no stanceJan 1, 2026payer document
BlueCross BlueShield of South CarolinaMolecular Diagnostics for Breast Cancer Prognosis (CAM 278)listed, no stanceApr 1, 2026payer document
CignaLaboratory Testing Services (0604)not coveredMay 15, 2026payer document

Medicaid fee-for-service

  • AZ: $211.16 (outpatient_hospital), effective Oct 1, 2021
  • CO: $55.02 (chp_plus, non-facility), effective Jul 1, 2026
  • FL: $75.13 (lab_independent, non-facility), effective Jan 1, 2026
  • IL: $102.45 (practitioner), effective Apr 1, 2024
  • IN: $84.10 (professional, Advanced Practice Nurse (85%), facility), effective Jan 1, 2026
  • KS: $23.77 (default, Exempt Physician), effective Jul 1, 2023
  • KY: $223.71 (lab), effective Jan 1, 2026
  • LA: $57.84 (lab_radiology), effective Jul 1, 2012
  • MA: $64.75 (physician_surgery), effective May 1, 2024
  • MS: $57.16 (comprehensive), effective Jul 1, 2026
  • ND: $34.92 (physician), effective Aug 1, 2026
  • NE: $239.60 (physician, non-facility), effective Jul 1, 2026
  • NY: $179.38 (lab), effective Aug 1, 2026
  • OH: $24.02 (lab), effective Apr 1, 2025
  • OK: $61.68 (physician, non-facility), effective Jul 1, 2026
  • TX: $84.44 (certified_nurse_midwife_cnm, Certified Nurse Midwife (Cnm), non-facility), effective Sep 1, 2025
  • VA: $63.95 (medical), effective Jul 1, 2026
  • VT: $278.32 (outpatient_hospital_opps), effective Feb 1, 2026
  • WA: $64.97 (kidneycenters), effective Jul 1, 2026
  • WY: $158.52 (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.