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PAYER POLICY CHANGES

80505 Insurance Policy Changes

CPT 80505, in plain terms, covers Pathology clinical consultation of high complexity with extensive record review, or 41 to 60 minutes of total time on the date when time is used to pick the level. No tracked policy changes reference CPT 80505 yet. New payer updates are added daily, so check back soon or create a free alert to be notified the moment a change affects this code.

Official descriptor: CPT 80505 on AAPC

No policies yet

No tracked policy changes match this filter yet. New policies are added daily.

Watch 80505

Get one email when a payer policy names 80505, a payer adds or drops it from a prior auth list, or Medicare changes its NCCI pairs, unit limit, payment or coverage articles.

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REFERENCE DATA

Payers with rules1
Payers requiring prior auth1
  • Centene · Effective December 31, 2025

    Prior authorization required

    Sunshine Health Title XIX, Title XXI, Managed Medical Assistance CMS-0057-F prior authorization requirements

FREQUENTLY ASKED QUESTIONS

Does Centene require prior authorization for 80505?

Centene lists 80505 on Sunshine Health Title XIX, Title XXI, Managed Medical Assistance CMS-0057-F prior authorization requirements for medicaid managed plans (list dated December 31, 2025). Verify with the payer before scheduling.

What insurance policy changes affect CPT 80505?

No policy changes affecting CPT 80505 have been tracked yet. Check back as coverage expands.

Which payers have updated policy for CPT 80505?

No payer-specific updates have been tracked for CPT 80505 yet.

How do I get notified when CPT 80505 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 80505. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for CPT 80505?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

See every payer rule for 80505

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 80505 in one place.

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