Reimbursement Information
Pregnancy Testing
Catalog No.Test DescriptionAMA
Recommended
CPT Code
Average
Reimbursement
FHC-101Pregnancy hCG Strip TestsUrine Testing - 81025$8.84
FHC-102Pregnancy hCG Cassette TestsUrine Testing - 81025$8.84
FHC-114Pregnancy hCG Dip Device TestsUrine Testing - 81025$8.84
FHC-202Pregnancy hCG Combo (Urine/Serum) TestsSerum Testing - 84703$10.49
Ovulation Testing
Catalog No.Test DescriptionAMA
Recommended
CPT Code
Average
Reimbursement
FLH-103LH Ovulation Predictor Midstream, 5 Day Test Kit84830$14.02
Strep A Testing
Catalog No.Test DescriptionAMA
Recommended
CPT Code
Average
Reimbursement
IST-501Strep A Strip - Waived87880QW$16.76
IST-502Strep A Cassette87880$16.76
IST-502TStrep A One-Step - Waived87880QW$16.76
h. Pylori Testing
   
Catalog No.Test DescriptionAMA
Recommended
CPT Code
Average
Reimbursement
IHP-402h. Pylori86318$18.09
 h. Pylori - Waived, Whole Blood86318QW$18.09
Mono Testing
Catalog No.Test DescriptionAMA
Recommended
CPT Code
Average
Reimbursement
IMO-402Mono86308$7.23
 Mono - Waived, Whole Blood86308QW$7.23
Drugs of Abuse Testing
Catalog No.Test DescriptionAMA
Recommended
CPT Code
Average
Reimbursement
VariesDrug Screen: Multiple Drug Classes *QW80100$20.32
VariesDrug Screen: Single Drug Class *QW80101$19.24


*Drug screening for routine work related issues or testing related to chemical dependency treatment are not covered. This test reports qualitative screening to detect the presence of specific drugs or classes of drugs.

** Add "QW" Modifier only to denote use of CLIA Waived product for Medicare and Medicaid Patients.
Important Note:
The list of CPT Codes and Average Reimbursement (estimates) are provided as suggestions and estimates only. The use and implementation of CPT codes and reimbursement levels on a state and/or federal basis may vary greatly in a given area and change over time. The relevant Medicare and/or Medicaid agencies may also take a view that the suggested CPT codes and/or reimbursement levels set forth herein are not applicable. Thus, the accuracy of these suggested CPT codes and reimbursement levels cannot be guaranteed. Please contact your own regional third party payers to confirm the correct CPT codes and reimbursement levels.

For state by state fee schedule go to www.cms.hhs.gov