CPT code 83036: A1c test, laboratory assay2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Hemoglobin A1c testing measures longer-term glycemic control and is reported for laboratory testing used to diagnose or monitor diabetes.
Medicare pays $9.71 for 83036 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
$9.71
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
- QW · CLIA-waived test
- $9.71
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 83036 covers
Hemoglobin A1c testing measures the proportion of hemoglobin with glucose attached, providing an estimate of average blood glucose over roughly the preceding two to three months. It is commonly ordered to assess or monitor diabetes. Clinical laboratories and office-based testing sites perform the assay on a blood specimen, typically whole blood.
Report 83036 for the laboratory A1c test; 83037 is the distinct code for testing by a device cleared for home use. CMS lists a CLIA-waived version of 83036 with modifier QW for sites holding a CLIA certificate of waiver. Medicare pays this test only through the CLFS. The 2026 national CLFS amount is $9.71, unchanged since 2020; one amount applies nationwide, without geographic or office-versus-facility adjustment.
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 83036
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 83036. 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 83036 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 83036 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $9.71.
83036 on the lab fee schedule since 2020
83036 · CLFS 2026 Q4 (current)
$9.71
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.
83036 compared with similar tests
- 83037A1c testFDA-cleared home-use device$9.71
- Both codes report A1c testing. Choose 83037 when testing uses a device cleared for home use; 83036 reports the laboratory assay.
- 83020Hemoglobin electrophoresisFractionation by electrophoresis$12.87
- 83020 evaluates hemoglobin types by electrophoresis; 83036 measures glycated hemoglobin for assessment of longer-term glycemia.
- 83021Hemoglobin analysisChromatography-based fractionation$18.06
- 83021 uses hemoglobin chromatography to evaluate hemoglobin types, rather than measuring A1c for glycemic assessment.
83036 billing questions
When should 83036 be reported instead of 83037?
Report 83036 for laboratory A1c testing. Use 83037 for A1c testing performed with a device cleared for home use.
When is modifier QW appropriate?
Append QW when reporting the CLIA-waived version of the test at a site holding a CLIA certificate of waiver.
What specimen is used for an A1c test?
A1c testing is generally performed on a blood specimen, typically whole blood.
How does Medicare pay for 83036?
Medicare pays 83036 through the CLFS, with one national amount across localities and settings. The test is excluded from the physician fee schedule.
Does 83036 measure a hemoglobin variant?
No. It measures glycated hemoglobin to assess longer-term glycemia; hemoglobin electrophoresis and chromatography evaluate hemoglobin types or variants.
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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