2025 Laboratory Fee Schedule
Fee schedules do not reflect 2% Payment Adjustment (Sequestration).
Click here for more information.
Please select your state before continuing:
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NCD-A National Coverage Determination Applies
LCD-A Local Coverage Determination Applies
LCA-A Local Coverage Article Applies
CCI-A Correct Coding Initiative edit Applies
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Point of Care
Index:
CLINITEST® Rapid COVID-19 Antigen Test
Urinalysis
Microalbumin
hCG
Hemoglobin A1C
Multistix® PRO
Xprecia Stride
CLINITEST® Rapid COVID-19 Antigen Test
| Product/Test |
CPT Code(s) |
CPT Code Description |
Medicare Coverage |
National
Reimbursement |
Urinalysis
| Product/Test |
Instrument System |
CPT Code(s) |
CPT Code Description |
Medicare Coverage |
National
Reimbursement |
Multistix® 10 SG
N-Multistix® SG
N-Multistix®
Multistix® 9
Multistix® 8
Multistix® 7
Multistix® PRO
Hema-Combistix
Combistix
Multistix® 2
Ictotest
Labstix
Microstix-3 |
Manual methods |
*Login Required |
Urinanalysis, non-automated, with microscopy |
CCI
|
$ 4.02 |
|
*Login Required |
non-automated, without microscopy |
CCI
|
$ 3.48 |
| CLIA Certificate of Waiver Methods |
Multistix® 10 SG
N-Multistix® SG
N-Multistix®
Multistix® 9
Multistix® 8
Multistix® 7
Multistix® PRO
Hema-Combistix
Combistix
Multistix® 2
Ictotest
Labstix
Microstix-3 |
CLINITEK® Atlas,
CLINITEK® 50, 100, 500 and Status, Status+, Status Connect Analyzers |
*Login Required |
Urinanalysis, automated, with microscopy |
CCI
|
$ 3.17 |
|
*Login Required -QW |
Urinanalysis, automated, without microscopy, CLIA Waived |
CCI
|
$ 2.25 |
| CLIA moderate/high complexity methods. |
Multistix® 10 SG
N-Multistix® SG
N-Multistix®
Multistix® 9
Multistix® 8
Multistix® 7
Multistix® PRO
Hema-Combistix
Combistix
Multistix® 2
Ictotest
Labstix
Microstix-3 |
CLINITEK® 50, 100, 500, Status, Status +, Status Connect Analyzers,
Advantus, AUW, AUWi, and UF-100 Analyzers |
*Login Required |
Urinanalysis, automated, with microscopy |
CCI
|
$ 3.17 |
|
*Login Required |
Urinanalysis, automated, without microscopy |
CCI
|
$ 2.25 |
CLINITEK® Microalbumin Reagent Strips - Product Code #2083, 25s
| Product/Test |
Instrument System |
CPT Code(s) |
CPT Code Description |
Medicare Coverage |
National
Reimbursement |
|
Both 82044 AND 82570 may be reported when measuring microalbumin plus creatinine using CLINITEK® Microalbumin Reagent Strips. |
| CLIA Certificate of Waiver Methods |
| Microalbumin |
CLINITEK® 50 Analyzer
CLINITEK® Status, Status+, Status Connect Analyzer
|
*Login Required -QW |
Albumin, urine, microalbumin, semiquantitative (eg, reagent strip assay) |
CCI
|
$ 6.23 |
| Creatinine |
*Login Required -QW |
Creatinine, other source |
CCI
|
$ 5.18 |
| CLIA moderate/high complexity methods. |
| Microalbumin |
CLINITEK® 100 Analyzer
CLINITEK® 50 Analyzer
CLINITEK® Status, Status+, Status Connect Analyzer
|
*Login Required |
Albumin, urine, microalbumin, semiquantitative (eg, reagent strip assay) |
CCI
|
$ 6.23 |
| Creatinine |
*Login Required |
Creatinine, other source |
CCI
|
$ 5.18 |
Clinitest hCG
| Product/Test |
Instrument System |
CPT Code(s) |
CPT Code Description |
Medicare Coverage |
National
Reimbursement |
| CLIA Certificate of Waiver Method |
| hCG |
CLINITEK® Status, Status+, Status Connect Analyzer |
*Login Required -QW |
Gonadotropin, chorionic (hCG); qualitative |
CCI
|
$ 7.52 |
| CLIA moderate/high complexity methods. |
| hCG |
CLINITEK® Status, Status+, Status Connect Analyzer |
*Login Required |
Gonadotropin, chorionic (hCG); qualitative |
CCI
|
$ 7.52 |
Hemoglobin A1C
| Product/Test |
Instrument System |
CPT Code(s) |
CPT Code Description |
Medicare Coverage |
National
Reimbursement |
| CLIA Certificate of Waiver Method |
| A1C |
DCA VantageTM Analyzer
DCA 2000+ Analyzer |
*Login Required -QW |
Hemoglobin A1C |
CCI
NCD
|
$ 9.71 |
| CLIA moderate/high complexity methods. |
| A1C |
DCA VantageTM Analyzer
DCA 2000+ Analyzer |
*Login Required |
Hemoglobin A1C |
CCI
NCD
|
$ 9.71 |
| Microalbumin |
*Login Required |
Microalbumin |
CCI
|
$ 5.78 |
| Creatinine |
*Login Required |
Creatinine, other source |
CCI
|
$ 5.18 |
Multistix® PRO
Non-Automated
| Product/Test |
Instrument System |
CPT Code(s) |
CPT Code Description |
Medicare Coverage |
National
Reimbursement |
Automated
| Product/Test |
Instrument System |
CPT Code(s) |
CPT Code Description |
Medicare Coverage |
National
Reimbursement |
| CLIA Certificate of Waiver Methods |
| Urinanalysis |
CLINITEK® Status, Status+, Status Connect Analyzers |
*Login Required -QW |
Urinanalysis, automated, without microscopy |
CCI
|
$ 2.25 |
| Creatinine |
*Login Required -QW |
Creatinine, other source |
CCI
|
$ 5.18 |
| CLIA moderate/high complexity methods. |
| Urinanalysis |
CLINITEK® Status, Status+, Status Connect Analyzers |
*Login Required |
Urinanalysis, automated, with microscopy |
CCI
|
$ 3.17 |
| Creatinine |
*Login Required |
Creatinine, other source |
CCI
|
$ 5.18 |
| Urinanalysis |
CLINITEK® Status, Status+, Status Connect Analyzers |
*Login Required |
Urinanalysis, automated, without microscopy |
CCI
|
$ 2.25 |
| Creatinine |
*Login Required |
Creatinine, other source |
CCI
|
$ 5.18 |
Xprecia Stride
| Product/Test |
Instrument System |
CPT Code(s) |
CPT Code Description |
Medicare Coverage |
National
Reimbursement |
National Coverage Determinations (NCD) - Medicare regulations allow the Center for Medicare and
Medicaid Services (CMS) to develop coverage policies for Medicare-covered tests and procedures. These
coverage policies, called NCDs, provide definitive guidance to providers concerning the medical necessity
requirements of a particular test or procedure. Numerous NCDs are in effect for a wide array of tests and
services including procedures performed by diagnostic service providers, such as radiologists and clinical laboratories.
Local Coverage Determinations (LCD) - Medicare contractors have the regulatory authority to develop local coverage determinations.
Unlike NCDs, these policies only apply to a single contractor jurisdiction. In the past, local policies were referred
to as Local Medical Review Policies (LMRPs).
Local Coverage Articles (LCA) - Medicare contractors have the regulatory authority to develop local coverage articles.
Unlike NCDs, these policies only apply to a single contractor jurisdiction.
Correct Coding Initiative (CCI) edits are used by Medicare to deny claims based on inappropriate CPT code usage.
CCI edits consist of pairs of CPT codes that Medicare has determined are not payable when performed together.
If a provider submits a claim containing two CPT codes that are the subject of a CCI edit, the Medicare carrier or
intermediary will deny one of the CPT codes. Many CCI edits may be overcome with the proper use of a CPT code modifier.
This information is provided as a convenience for Siemens Healthcare employees and users by
CodeMap®. CodeMap® is responsible
for the accuracy of all content. 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 the specific location, the number and type of
clinical procedures performed, and the local carrier coverage and payment policies. Note also
that the federal statute known as the Stark Law imposes certain requirements that must be met in
order for physicians to bill Medicare/Medicaid or other federal healthcare programs for in-office
services provided. In some states, similar laws cover billing practices for all patients.
Additional licensure, certificate of need, and other restrictions may be applicable.
It is the responsibility of each physician, physician group, and other individuals and entities
to consult with their reimbursement manager or healthcare advisor, as well as legal counsel,
to ensure all requirements have been met to support appropriate billing for Medicare services
provided.
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04/25/2025 12:22:51 18.222.32.191
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