2024 Clinical Laboratory Fee Schedule Information


Please select your state before continuing:

HIV
DPP® HIV 1/2 Assay
Sure Check® HIV
HIV 1/2 STAT-PAK® Assay

Chembio strongly recommends that providers contact their payors to determine appropriate coding prior to submitting claims for HIV testing.
CPT Code
CPT Code Description
Medicare Coverage
National
Medicare
Reimbursement1
National
Medicaid
Reimbursement
86703
Antibody; HIV-1 and HIV-2, single result
  CCI   MUE   NCD
$ 13.71
N/A
G0435-QW
Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening
  MUE   NCD
$ 11.98
N/A


HIV/Syphilis



Test Name
CPT Code
CPT Code Description
Medicare Coverage
National
Medicare
Reimbursement1
National
Medicaid
Reimbursement
DPP® HIV- Syphilis
(Fingerstick whole blood)
86703
Antibody; HIV-1 and HIV-2, single result
  CCI   MUE   NCD
$ 13.71
N/A
86780-QW
Antibody; Treponema pallidum
  CCI   MUE   NCD
$ 13.24
N/A
G0433-QW
Infectious agent antibody detection by enzyme-linked immunosorbent assay (elisa) technique, hiv-1 and/or hiv-2, screening
  CCI   MUE   NCD
$ 18.29
N/A
G0435-QW
Infectious agent antibody detection by rapid antibody test, hiv-1 and/or hiv-2, screening
  MUE   NCD
$ 11.98
N/A


Flu A & B



Test Name
CPT Code
CPT Code Description
Medicare Coverage
National
Medicare
Reimbursement1
National
Medicaid
Reimbursement
Status Flu A & B
87804-QW
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza
  CCI   MUE  
$ 16.55
N/A
87804-QW-59
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza
  CCI   MUE  
$ 16.55
N/A


COVID-19/FLU



Test Name
CPT Code
CPT Code Description
Medicare Coverage
National
Medicare
Reimbursement1
National
Medicaid
Reimbursement
Status COVID-19/FLU
87811-QW
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])
  CCI   MUE  
$ 41.38
N/A
87804-QW
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza
  CCI   MUE  
$ 16.55
N/A
87804-QW-59
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; Influenza
  CCI   MUE  
$ 16.55
N/A


COVID-19 Antigen Test



Test Name
CPT Code
CPT Code Description
Medicare Coverage
National
Medicare
Reimbursement1
National
Medicaid
Reimbursement
SCoV-2 Ag Detect Rapid Self-Test
87811-QW
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])
  CCI   MUE  
$ 41.38
N/A
Advin COVID-19 Antigen Test @Home

NDC Code:
60010-003312
60010-003310
87811-QW
Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19])
  CCI   MUE  
$ 41.38
N/A

1Medicare Reimbursement Amount does not reflect 2% Sequestration adjustment. Click here for more information.

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