Horizon Blue Cross Blue Shield of New Jersey
09/02/2026 | Press release | Distributed by Public on 09/02/2026 05:28
New Policy: Eligible Laboratory Tests Performed in an Office Setting
Effective December 1, 2026, Horizon will implement the Eligible Laboratory Tests Performed in an Office Setting reimbursement policy. Under this policy, only certain laboratory services will be considered for reimbursement when performed in a physician's office setting for members enrolled in Horizon plans and products.
All products/lines of business are included for Horizon BCBSNJ and Braven Health, except:
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Coordination of Benefits (COB)
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Blue Card Home (Par Only)
The table below lists the laboratory procedure codes, organized by physician specialty, that we will consider for reimbursement when rendered in participating and non-participating physician's office
| Specialist | CPT Codes |
| Advanced Nurse Practitioner, Family Nurse Practitioner, Nurse Practitioner, & Pediatrics-Nurse Practitioner | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82948, 82962, 83014, 83026, 83655, 84703, 85013, 85014, 85018, 85025, 85610, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804, 87807, 87880, 88738 |
| All Specialties | 87811 |
| Anesthesiology | 80305, 80306 |
| Dermatology | 87172, 87210, 87220 |
| Endocrinology | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82948, 82962, 83014, 83026, 83655, 84703, 85013, 85014, 85018, 85025, 85610, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804, 87807,87880, 88738 |
| Family Practice | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82948, 82962, 83014, 83026, 83655, 84703, 85013, 85014, 85018, 85025, 85610, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804, 87807,87880, 88738 |
| Gynecologic Oncology | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82670, 82948, 82962, 83001, 83002, 83014, 83026, 83655, 84144, 84703, 85013, 85014, 85018, 85025, 85610, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804, 87807,87880, 88141, 88142, 88738, 89250, 89253, 89254, 89255, 89257, 89260, 89261, 89264, 89268, 89272, 89280, 89281, 89300, 89310, 89320, 89321, 89325, 89330 |
| Gynecology | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82670, 82948, 82962, 83001, 83002, 83014, 83026, 83655, 84144, 84703, 85013, 85014, 85018, 85025, 85610, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804, 87807, 87880, 88141, 88142, 88738, 89250, 89253, 89254, 89255, 89257, 89260, 89261, 89264, 89268, 89272, 89280, 89281, 89300, 89310, 89320, 89321, 89325, 89330 |
| Hematology | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82948, 82962, 83014, 83026, 83655, 84703, 85007, 85013, 85014, 85018, 85025, 85027, 85060, 85097, 85576, 85610, 85660, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804, 87807,87880, 88172, 88738 |
| Hematology/Oncology | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82948, 82962, 83014, 83026, 83655, 84703, 85007, 85013, 85014, 85018, 85025, 85027, 85097, 85576, 85610, 85660, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804,87807, 87880, 88172, 88738 |
| Internal Medicine | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82948, 82962, 83014, 83026, 83655, 84703, 85013, 85014, 85018, 85025, 85610, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804, 87807,87880, 88738 |
| Obstetrics & Gynecology | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82670, 82948, 82962, 83001, 83002, 83014, 83026, 83655, 84144, 84703, 85013, 85014, 85018, 85025, 85610, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804, 87807,87880, 88141, 88142, 88738, 89250, 89253, 89254, 89255, 89257, 89260, 89261, 89264, 89268, 89272, 89280, 89281, 89300, 89310, 89320, 89321, 89325, 89330 |
| Oncology | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82948, 82962, 83014, 83026, 83655, 84703, 85007, 85013, 85014, 85018, 85025, 85027, 85097, 85576, 85610, 85660, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804,87807, 87880, 88172, 88738 |
| Ophthalmology | 83516, 83861 |
| Optometrist | 83516, 83861 |
| Pain Management | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82948, 82962, 83014, 83026, 83655, 84703, 85013, 85014, 85018, 85025, 85610, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804, 87807,87880, 88738 |
| Pediatrics | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82948, 82962, 83014, 83026, 83655, 84703, 85013, 85014, 85018, 85025, 85610, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804, 87807,87880, 88738 |
| Physical Medicine & Rehabilitation | 80305, 80306 |
| Physician Assistant | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82948, 82962, 83014, 83026, 83655, 84703, 85013, 85014, 85018, 85025, 85610, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804, 87807,87880, 88738 |
| Reproductive Endocrinology | 80305, 80306, 81000, 81001, 81002, 81003, 81015, 81025, 82044, 82247, 82270, 82271, 82272, 82274, 82670, 82948, 82962, 83001, 83002, 83014, 83026, 83655, 84144, 84703, 85013, 85014, 85018, 85025, 85610, 86308, 86485, 86486, 86490, 86510, 86580, 81777, 87210, 87220, 87804, 87807,87880, 88141, 88142, 88738, 89250, 89253, 89254, 89255, 89257, 89260, 89261, 89264, 89268, 89272, 89280, 89281, 89300, 89310, 89320, 89321, 89322, 89325, 89330, 89352 |
| Urology | 81000, 81001, 81002, 81003, 81015, 82044, 82270, 82271, 82272, 82948, 82962, 86580, 89060, 89300, 89310, 89320, 89321, 89322 |
Laboratory tests performed in a physician's office that are not included on the eligible procedure list will not be considered for reimbursement under this policy.
This policy applies to professional claims submitted by both participating and non-participating providers and supports our ongoing commitment to improving access to care, lowering overall healthcare costs and enhancing the member experience.
ECN0027513 (0826)
Published on: September 2, 2026, 01:21 a.m. ET
Last updated on: September 2, 2026, 07:22 a.m. ET
Horizon Blue Cross Blue Shield of New Jersey published this content on September 02, 2026, and is solely responsible for the information contained herein. Distributed via Public Technologies (PUBT), unedited and unaltered, on September 02, 2026 at 11:28 UTC. If you believe the information included in the content is inaccurate or outdated and requires editing or removal, please contact us at [email protected]