CodeMap-Biofire Coding Support

Should you have additional questions after reviewing CodeMap, please contact biofiredx@codemap.com

Disclaimer: This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice. Note that payers that follow NCCI guidance may recommend the use of alternate code(s). bioMerieux recommends providers consult with their Medicare Administrative Contractor to confirm the applicable Medicare coding and coverage guidance. It is always the provider’s responsibility to determine and submit appropriate codes for services that are rendered, consistent with applicable payer guidance. bioMerieux recommends that you consult with your payer, reimbursement specialist and/or legal counsel regarding coding, coverage, and reimbursement matters. Payer coding, coverage, and reimbursement policies may vary, are subject to change, and should be verified prior to claim submission

2025 Medicare / Medicaid Coding and Fee Schedule Reference

Please select a product category:

BIOFIRE^®FILMARRAY^® BIOFIRE^® SPOTFIRE^® VIDAS^® 3

Fee Schedule information comes from the Medicare Clinical Laboratory Fee schedule (CLFS) and the state's Medicaid Fee schedule. The rates listed are as they appear on the respective fee schedule. A published rate is not an indication of coverage for any test. Please review the appropriate Medicare LCD/LCA or the state's Medicaid program for detailed coverage information.

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Test Name Analyte CPT^® Code Description Medicare Coverage and Rules National
CLFS Fee Schedule¹ National
Medicaid
Fee Schedule²

BIOFIRE^®SPOTFIRE^® Respiratory (R) Panel Mini
SARS-CoV-2
Human rhinovirus/enterovirus
Influenza A virus (2 Markers)
Influenza B virus
Respiratory syncytial virus 87631 Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes,
3-5 targets CCI MUE $142.63 N/A

BIOFIRE^®SPOTFIRE^® Respiratory (R) Panel
Adenovirus
Coronavirus (Seasonal)
SARS-CoV-2
Human metapneumovirus
Human rhinovirus/enterovirus
Influenza A virus (2 markers)
Influenza B virus
Parainfluenza virus
Respiratory syncytial virus 87632 Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes,
6-11 targets CCI MUE $218.06 N/A

Chlamydia pneumoniae 87486 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique CCI MUE $ 35.09 N/A

Mycoplasma pneumoniae 87581 Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique CCI MUE $ 35.09 N/A

Bordetella parapertussis 87798 Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism CCI MUE $ 35.09 N/A

Bordetella pertussis 87798 Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism CCI MUE $ 35.09 N/A

BIOFIRE^® SPOTFIRE^®
Respiratory / Sore Throat (R/ST) Panel - R Panel

Applicable for use through June 30, 2025 Adenovirus
Coronavirus (Seasonal)
SARS-CoV-2
Human metapneumovirus
Human rhinovirus/enterovirus
Influenza A virus (2 markers)
Influenza B virus
Parainfluenza virus
Respiratory syncytial virus 87632 Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes,
6-11 targets CCI MUE $218.06 N/A

Chlamydia pneumoniae 87486 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique CCI MUE $ 35.09 N/A

Mycoplasma pneumoniae 87581 Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique CCI MUE $ 35.09 N/A

Bordetella parapertussis 87798 Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism CCI MUE $ 35.09 N/A

Bordetella pertussis 87798 Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism CCI MUE $ 35.09 N/A

BIOFIRE^®SPOTFIRE^® Respiratory / Sore Throat (R/ST) Panel - R Panel

Available for use
July 1, 2025 Adenovirus
Coronavirus (Seasonal)
SARS-CoV-2
Human metapneumovirus
Human rhinovirus/enterovirus
Influenza A virus (2 markers)
Influenza B virus
Parainfluenza virus
Respiratory syncytial virus
Chlamydia pneumoniae
Mycoplasma pneumoniae
Bordetella parapertussis
Bordetella pertussis 0563U Infectious disease (bacterial and/or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 11 viral targets and 4 bacterial targets, qualitative RT-PCR, upper respiratory specimen, each pathogen reported as positive or negative N/A N/A

BIOFIRE^® SPOTFIRE^®
Respiratory / Sore Throat (R/ST) Panel -
ST Panel

Applicable for use through June 30, 2025 Adenovirus
Coronavirus (Seasonal)
SARS-CoV-2
Human metapneumovirus
Human rhinovirus/enterovirus
Influenza A virus (2 markers)
Influenza B virus
Parainfluenza virus
Respiratory syncytial virus 87632 Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes,
6-11 targets CCI MUE $218.06 N/A

Chlamydia pneumoniae 87486 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia pneumoniae, amplified probe technique CCI MUE $ 35.09 N/A

Mycoplasma pneumoniae 87581 Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma pneumoniae, amplified probe technique CCI MUE $ 35.09 N/A

Streptococcus dysgalactiae (group C/G) 87798 Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; amplified probe technique, each organism CCI MUE $ 35.09 N/A

Streptococcus pyogenes (group A) 87651 Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique CCI MUE $ 35.09 N/A

BIOFIRE^®SPOTFIRE^® Respiratory / Sore Throat (R/ST) Panel - ST Panel

Available for use
July 1, 2025 Adenovirus
Coronavirus (Seasonal)
SARS-CoV-2
Human metapneumovirus
Human rhinovirus/enterovirus
Influenza A virus (2 markers)
Influenza B virus
Parainfluenza virus
Respiratory syncytial virus
Chlamydia pneumoniae
Mycoplasma pneumoniae
Streptococcus dysgalactiae (group C/G)
Streptococcus pyogenes (group A)
0564U Infectious disease (bacterial and/or viral respiratory tract infection), pathogen-specific nucleic acid (DNA or RNA), 10 viral targets and 4 bacterial targets, qualitative RT-PCR, upper respiratory specimen, each pathogen reported as positive or negative N/A N/A

BIOFIRE^® SPOTFIRE^®
Respiratory / Sore Throat (R/ST) Panel
Mini - R Panel
SARS-CoV-2
Human rhinovirus
Influenza A virus
Influenza B virus
Respiratory syncytial virus 87631 Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes,
3-5 targets CCI MUE $142.63 N/A

BIOFIRE^® SPOTFIRE^®
Respiratory / Sore Throat (R/ST) Panel
Mini - ST Panel
Human rhinovirus
Influenza A virus
Influenza B virus
Respiratory syncytial virus 87631 Infectious agent detection by nucleic acid (DNA or RNA); respiratory virus (eg, adenovirus, influenza virus, coronavirus, metapneumovirus, parainfluenza virus, respiratory syncytial virus, rhinovirus), includes multiplex reverse transcription, when performed, and multiplex amplified probe technique, multiple types or subtypes,
3-5 targets CCI MUE $142.63 N/A

Streptococcus pyogenes (group A) 87651 Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, amplified probe technique CCI MUE $ 35.09 N/A

The QW modifier is required for tests performed by laboratories holding Certificate of Waiver (COW) and Provider Performed Microscopy (PPM) certificates.

¹National CLFS Fee Schedule Amount does not reflect 2% Sequestration adjustment. Click here for more information.

bioMérieux makes no warranties, express, implied or statutory, including, but not limited to, warranties of merchantability, fitness for a particular purpose and/or non-infringement. bioMérieux assumes no responsibility for omissions or errors contained on this site. This information presents no promise, commitment, statement or guarantee by bioMérieux concerning proper billing or coding practices or levels of payment or charges. This information does not constitute reimbursement or legal advice. The existence of codes does not guarantee coverage or payment for any procedure by any payer. The healthcare provider is solely responsible for determining the appropriate coverage, coding and payment policies for individual patients.

To ensure compliance with Federal and State laws and regulations, including HIPAA, bioMérieux is unable to provide specific billing guidance, and/or support with patient appeals.

bioMérieux does not recommend codes for specific cases. bioMérieux does not promote the off-label use of its diagnostic tests.

For more information, please visit the bioMérieux website: www.biomerieux-diagnostics.com

The information contained in this website has been compiled by CodeMap, L.L.C. who remains solely responsible for its content. The information provided is for general educational purposes only and may not be conclusive or exhaustive. Reimbursement information does not indicate overage for these services. While every effort is made to ensure that all payment amounts and regulatory information is current and complete, it is the responsibility of each user to verify specific coverage and payment information with their Medicare contractors. Actual reimbursement for healthcare facilities will vary depending on local carrier coverage and payment policies. Recent changes in applicable law, regulations and interpretations may not be reflected in the information contained herein. For technical questions, please contact CodeMap at (847) 381-5465.

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