CPT code 81412: Disorder gene panel, ashkenazi-associated conditions2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Report 81412 for genomic sequencing of a panel of at least nine genes associated with disorders linked to Ashkenazi Jewish ancestry.
Medicare pays $2,448.56 for 81412 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
$2,448.56
In effect since Jan 1, 2026. The same amount in every state, payment locality and setting.
- Geographic adjustment
- None
- Office vs facility
- Same
- Since 2020
- 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 8 sections
What 81412 covers
81412 describes genomic sequence analysis of a multigene panel for disorders associated with Ashkenazi Jewish ancestry. The panel must include at least nine genes, including ASPA, BLM, CFTR, FANCC, GBA, HEXA, IKBKAP, MCOLN1, and SMPD1. Associated conditions include Bloom syndrome, Canavan disease, cystic fibrosis, familial dysautonomia, Fanconi anemia group C, Gaucher disease, and Tay-Sachs disease. This targeted panel differs from single-gene testing and broader exome or genome analysis.
Report 81412 for the qualifying genomic panel. Medicare pays it only under the CLFS, at one national amount across states and localities, with no office-versus-facility difference. The 2026 national CLFS amount is $2,448.56, unchanged since 2020. The test is excluded from the physician fee schedule.
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 81412
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 81412. 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.
Excluded from the physician fee schedule
The physician fee schedule lists 81412 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81412 on the lab fee schedule since 2020
81412 · CLFS 2026 Q4 (current)
$2,448.56
Unchanged since Jan 1, 2020
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
81412 compared with similar tests
- 81415Exome analysisInitial sequence analysis$4,780.00
- 81412 describes a targeted panel for Ashkenazi-associated disorders. 81415 describes exome sequencing, a broader analysis.
- 81425Genome sequencingConstitutional or heritable disorders$5,031.20
- 81412 describes a targeted panel of at least nine genes. 81425 describes genome sequencing, a broader analysis.
81412 billing questions
How many genes must the panel include?
The panel must include sequencing of at least nine genes, including ASPA, BLM, CFTR, FANCC, GBA, HEXA, IKBKAP, MCOLN1, and SMPD1.
Does 81412 describe a single-gene test?
No. It describes genomic sequencing of a multigene panel for Ashkenazi-associated disorders.
How does 81412 differ from exome or genome sequencing?
81412 describes a targeted panel of at least nine genes. Exome and genome sequencing codes describe broader sequencing approaches.
How does Medicare pay for 81412?
Medicare pays 81412 only through the CLFS. The same national amount applies across localities and office and facility settings.
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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