CLIA waived CPT list with fee amount

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.