payment for CLIA waived CPT codes

CLIA Waived Tests for Manufacturers

Clinical Laboratory Improvement Amendment of 1988 (CLIA). The CLIA-waived status allows a broad base of physicians to perform a test at the point-of-care setting.
CPT CODE
MEDICARE FEE CAP
TEST NAME (SELECTED PRODUCTS/MANUFACTURERS)
82055QW
$15.10
Alcohol Saliva Test (STC Diagnostics, QED Diagnostics)
82120QW
$5.25
Amines and pH (Advance Amines and pH test, Quidel, BV Blue, Sekisui Diagnostics)
83986QW
$5.00
Amines and pH (Advance Amines and pH test, Quidel, BV Blue, Sekisui Diagnostics)
85576QW
$30.01
Aspirin resistance test (VerifyNow Accumetrics)
87905QW
$17.20
Bacterial Vaginosis (Sekisui Diagnostics)
83518QW
$11.85
Bladder Cancer Antigen (BTA Stat Test Bion Diagnostics)
83880QW
$47.43
BNP test (Triage Meter, Biosite Corp)
87324
$16.88
C. difficille (Sekisui Diagnostics)
Varies
Varies
Chemistry Tests: Albumin, Alkaline Phosphatase, Amylase, GGT, Total Bilirubin, Total Protein (Abaxis Piccollo)
82465QW
$6.08
Cholesterol (Chemtrak, J & J, Roche, Actimed Labs, Lifestream Technologies)
82044QW
$6.44
Dipstick Albumin (Chemstrip Micral Roche Corp, Immunodip, DCL, Sekisui Diagnostics)
81002
$3.57
Dipstick/Tablet Urinalysis
81002
$3.57
Dipstick Urinalysis
82570QW
$7.23
Creatinine (Bayer Multistix Pro 11, 10LS, 7G)
81003QW
82570QW
$3.14
$7.23
Dipstick Urine Analyzer (Clinitek 50 Bayer Corp.; Urisys Roche Corp.)+ Creatinine (Bayer Status Analyzer)
80101QW
$19.24
Drugs of Abuse tests
82272
$4.54
FOB, Diagnostic (Hemoccult Beckman Coulter, Seroccult Propper)
82270
$4.54
FOB, Screening
G0394
$4.54
FOB, single test for colorectal neoplasm
82274QW or G0328
$22.22
FOB, Immunoassay (InSure Enterix, FOB Alfa Scientific, Hemoccult ICT Beckman Coulter, Instant Technologies, Immunostics)
83001QW
$25.97
FSH (Biotechnostics, Menocheck Pro FSH Menopause Test)
82273QW
$4.54
Gastric Occult Blood (Beckman Coulter)
82962
$3.27
Glucose Meters
82951QW
$17.99
Glucose Tolerance Test, 3 Specimens
82947QW
$5.48
Glucose (HemoCue Glucose 201 Analyzer)
83036QW
$13.56
Hemoglobin A1c (Axis-Shield Afinion, Bayer DCA 2000)
83037QW
$21.06
Hemoglobin A1c, approved for home use (Cholestech, Metrika, BioRad, Provalis)
85014QW
$3.31
Hematocrit (StatSpin)
85018QW
$3.31
Hemoglobin (Hemocue)
86318QW
$18.22
H. pylori test whole blood (Quidel, BD, Accutest, Instant Technologies, Sekisui Diagnostics)
87338QW
$20.10
H. pylori test, stool (Meridian Bioscience, Immunocard)
86703QW
$19.17
HIV Rapid Test (OraSure)
87804QW
$16.88
Influenza Rapid Test Kits (Quidel, Binax, Sekisui Diagnostics)
83655QW
$16.91
LeadCare II Blood Lead Test System (ESA Biosciences, Chelmsford, MA)
80061QW
$18.72
Lipid Panel (Cholestech, Abaxis, Cardiocheck) (Cholest, HDL, Triglycerides)
84460QW
$7.40
ALT (SGPT)
84450QW
$7.40
AST (SGOT)
83721QW
$13.33
LDL (Polymer Technology; Cardiocheck PA)
86618QW
$23.80
Lyme Disease Rapid Test Kit (Inverness)
82043QW
$8.09
Microalbumin, Urine Quantitative (Hemocue)
83518QW
$11.85
Microalbumin Immunoassay (ICON Beckman Coulter)
86308QW
$7.28
Mononucleosis Test Kits (Quidel, Inverness, Sekisui Diagnostics)
80101QW
$19.24
Nicotine Test (NicCheck, Dynagen)
84830
$14.02
Ovulation Test Kits (Instant Technologies)
81025
$8.90
Pregnancy Test Kits Urine, Qualitative (Beckman Coulter, Sekisui Diagnostics, Quidel, Inverness)
84703QW
$10.49
Pregnancy Test Urine Instrument (Clinitek Bayer Corp)
85610QW
$5.49
Prothrombin Time (Protime ITC Corp, CoaguChek Roche, Hemosense)
87807QW
$16.76
RSV Rapid Test Kit (Binax, Integrated Biotechnology)
85651
$4.96
Sedimentation Rate, Non-Automated
87880QW
$16.88
Strep Rapid Test Kits (Beckman Coulter, Sekisui Diagnostics, Quidel, BD, Inverness, Sekisui Diagnostics, etc.)
87808QW
$16.88
Trichomonas Rapid Test Kit (Sekisui Diagnostics)
84443QW
$23.47
TSH, qualitative (Thyrotech)
81007QW
$3.59
Urinary Tract Infections (Uriscreen Diatech Diagnostics)
This list omits certain waived tests that are typically not performed in physician office settings.

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