CPT code 84146: Prolactin, pituitary hormone level2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Measures prolactin in blood for evaluation of galactorrhea, menstrual irregularities, infertility, or suspected pituitary disease.
Medicare pays $19.38 for 84146 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
$19.38
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 84146 covers
Prolactin is a pituitary hormone involved in milk production. A blood measurement, commonly from serum, is used to evaluate galactorrhea, amenorrhea or other menstrual irregularities, infertility, and suspected pituitary disease; it can also be used to monitor hyperprolactinemia. Primary care clinicians, endocrinologists, and gynecologists may order the test, and clinical laboratories perform the assay. The result helps assess prolactin levels in these clinical settings.
Report 84146 for prolactin measurement. Medicare pays this test only through the CLFS, at one national amount that applies across states and localities without an office-versus-facility adjustment. The 2026 national CLFS amount is $19.38, unchanged since 2020. The test is excluded from the physician fee schedule by statute.
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 84146
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 84146. 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 84146 with status X (excluded by statute), so the test itself is paid only from the CLFS.
84146 on the lab fee schedule since 2020
84146 · CLFS 2026 Q4 (current)
$19.38
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.
84146 compared with similar tests
84146 billing questions
When should 84146 be chosen instead of 84144?
Use 84146 for prolactin measurement and 84144 for progesterone measurement. Select the code for the hormone assayed.
What specimen is used for prolactin testing?
The test measures prolactin in blood, commonly using serum.
Can prolactin be reported with other hormone tests?
It may be ordered alongside tests such as FSH, LH, or TSH during an evaluation. Report the code for each separately performed assay.
How does Medicare pay for 84146?
Medicare pays 84146 only through the CLFS, using one national amount across localities and 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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