CPT code 0203U: IBD gene profile, 17-gene whole-blood assay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This whole-blood 17-gene mRNA assay reports an IBD aggressiveness risk score and classification for the defined molecular profile.
Medicare pays $760.00 for 0203U under the 2026 Clinical Laboratory Fee Schedule: one national amount, the same in every state and setting.
Medicare lab fee · CLFS 2026 Q4
National CLFS amount
$760.00
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2021
- Unchanged
- CMS updates
- Quarterly
Medicare pays the lesser of the lab’s charge and this amount. Patients usually owe no Part B deductible or coinsurance for covered clinical lab tests.
On this page 7 sections
What 0203U covers
This laboratory assay measures expression of 17 genes in a whole-blood specimen using quantitative RT-PCR. Its profile includes 15 target genes and two reference genes, and the report gives a continuous risk score with a classification of inflammatory bowel disease aggressiveness. The code identifies this defined molecular profile for the assay.
Report 0203U for the defined 17-gene assay. Medicare pays the test through the Clinical Laboratory Fee Schedule (CLFS), at one national amount across states and localities, without geographic or office-versus-facility adjustment. The 2026 national CLFS amount is $760.00, unchanged from 2021 through 2026. Medicare pays this code only through the CLFS; there is no physician fee schedule payment row for the code.
This summary was written with AI assistance from CMS Clinical Laboratory Fee Schedule data. Amounts on this page come directly from CMS files.
How Medicare pays 0203U
Clinical lab tests aren’t priced like physician services. They’re paid from their own fee schedule, with its own rules. See the whole lab fee schedule.
One national amount
CMS sets a single Clinical Laboratory Fee Schedule amount for 0203U. There’s no geographic (GPCI) adjustment, so it pays the same in every state and payment locality.
No office or facility rate
Lab tests aren’t built from relative value units, so there’s no office and facility split: the place of service doesn’t change the CLFS amount.
Updated every quarter
CMS republishes the CLFS each quarter. New tests, often proprietary laboratory analyses (PLA codes), join during the year; existing amounts are updated each January.
Not on the physician fee schedule
The physician fee schedule doesn’t list 0203U: Medicare pays the test only from the CLFS.
0203U on the lab fee schedule since 2020
0203U · CLFS 2026 Q4 (current)
$760.00
Unchanged since Jan 1, 2021
Every change on file
- Jan 1, 2021 · CLFS 2021 Q1MAC-priced → $760.00
25 quarterly CLFS releases on file, first CLFS 2020 Q4. A code missing from a quarter wasn’t on that release.
0203U compared with similar tests
- 81479Molecular pathologyUnlisted procedureNo national amount
- 0203U identifies the defined 17-gene IBD expression profile; 81479 is an unlisted molecular pathology code rather than the specific code for this assay.
- 83993CalprotectinStool protein level$19.63
- 83993 measures fecal calprotectin, a stool marker of intestinal inflammation; it does not profile IBD-related gene expression or report an aggressiveness classification.
- 86140CRP testStandard CRP assay$5.18
- 86140 measures C-reactive protein. It is an inflammatory marker test, not a whole-blood 17-gene expression profile.
0203U billing questions
What result does this assay report?
It reports a continuous risk score and a classification of inflammatory bowel disease aggressiveness based on expression profiling of 17 genes in whole blood.
Which specimen and method are associated with 0203U?
The assay uses whole blood and quantitative RT-PCR to profile 15 target genes and two reference genes.
Should an unlisted molecular pathology code be used instead?
Use 0203U when the performed assay matches this defined 17-gene IBD profile. Code 81479 is an unlisted molecular pathology code, not the specific code for this assay.
Does Medicare pay a separate physician interpretation for 0203U?
Medicare pays 0203U through the CLFS, with no separate physician fee schedule payment row for the code.
Where this amount comes from
FeeBase reads lab amounts directly from the CMS Clinical Laboratory Fee Schedule file for the quarter: one row per code, with its payment indicator and national amount. Contractor-priced tests are labeled, never given a made-up amount. Amounts are Medicare payment limits, not a patient’s bill or a commercial rate.
CMS CLFS 2026 Q4 · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file line behind this amount
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