Reimbursement Information
Drugs of Abuse Testing
UPDATE: On Jan. 1, 2011 the Centers for Medicare and Medicaid Services (CMS) issued new reimbursement guidelines for Drugs of Abuse testing.
DISCLAIMER: The attached FAQs are our summary and interpretation only of the CMS materials currently available. Under no circumstances does Alfa guarantee reimbursement by private insurance carriers or Medicare/Medicaid. Always refer to CMS or your relevant insurance carrier for up-to-date and state by state reimbursement information.
The following files have been provided for your convenience:
• Reimbursement FAQs – Jan. 2011
• HCPCS Coding Jan. 2011
However for more complete details of these specific changes it is important to visit www.cms.gov.
Other commonly used CPT codes (non-DOA) as of 2017:
| Product | Avg. Reimbursement | CPT Code |
| hCG Pregnancy Urine Test Strip, Cassette, or Midstream | $8.84 | 81025 |
| hCG Pregnancy Urine/Serum Test Strip or Cassette | $10.49 | 84703 |
| LH Ovulation Urine Test Strip, Cassette, or Midstream | $14.02 | 84830 |
| H. Pylori Serum Test Strip or Cassette | $18.09 | 86318 |
| H. Pylori Whole Blood/Serum Test Strip or Cassette | $18.09 | 86318 |
PLEASE NOTE: The above listed CPT Codes and Average Reimbursements are provided as suggestions and estimates only and are subject to change and should not be considered guaranteed. The estimated reimbursement rates are based off of information gathered from www.repertoiremag.com. For the most current information on state by state fee schedules visit www.cms.hhs.gov
