2025 Clinical Laboratory Fee Schedule Information
Please select your state before continuing:
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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
|
| 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 |
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 |
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.
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