CPT code 81442: Noonan panel, multigene sequence analysis2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Genomic sequencing of a panel of at least 12 genes evaluates Noonan spectrum disorders, including Noonan syndrome and related conditions.
Medicare pays $2,143.60 for 81442 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
$2,143.60
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 81442 covers
Code 81442 represents genomic sequencing of a multigene panel for Noonan spectrum disorders. The panel includes at least 12 genes, including BRAF, CBL, HRAS, KRAS, MAP2K1, MAP2K2, NRAS, PTPN11, RAF1, RIT1, SHOC2, and SOS1. The conditions addressed include Noonan syndrome and related disorders such as cardio-facio-cutaneous, Costello, LEOPARD, and Noonan-like syndromes. A clinical molecular laboratory performs the sequencing and reports the panel result.
Report 81442 once for the panel rather than separately for its genes. Medicare pays it under the CLFS at one national amount across states and localities, without an office or facility adjustment. The 2026 national CLFS amount is $2,143.60, unchanged since 2020. The test is excluded from the physician fee schedule and paid only through the CLFS.
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 81442
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 81442. 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 81442 with status X (excluded by statute), so the test itself is paid only from the CLFS.
81442 on the lab fee schedule since 2020
81442 · CLFS 2026 Q4 (current)
$2,143.60
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.
81442 compared with similar tests
- 81425Genome sequencingConstitutional or heritable disorders$5,031.20
- 81442 is a focused panel for Noonan spectrum disorders; 81425 represents genome sequence analysis rather than this targeted panel.
- 81443Inherited conditions panelAt least 15 genes$2,448.56
- 81442 is specific to Noonan spectrum disorders; 81443 describes genetic testing for severe inherited conditions.
81442 billing questions
How many genes must the panel include?
The panel must include sequencing of at least 12 genes, including BRAF, CBL, HRAS, KRAS, MAP2K1, MAP2K2, NRAS, PTPN11, RAF1, RIT1, SHOC2, and SOS1.
Should each gene on the panel be reported separately?
No. Report 81442 once for the multigene panel analysis rather than as separate services for each gene.
How does 81442 differ from whole-genome sequencing?
81442 represents a panel directed at Noonan spectrum disorders; 81425 represents genome sequence analysis.
Does Medicare pay this test under the physician fee schedule?
No. Medicare pays 81442 through the CLFS, with one national amount across localities and care 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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