CPT code 86005: IgE screen, qualitative, multiple allergens2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Qualitative multiallergen IgE screening is reported for laboratory testing of antibodies to multiple allergic substances.
Medicare pays $7.97 for 86005 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
$7.97
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 86005 covers
86005 reports a qualitative IgE screen directed at multiple allergic substances. The screening format may use a disk, sponge, or card. It differs from testing directed to one allergen at a time: the reported service is the multiallergen screen, not a separate 86005 unit for every allergen represented. Results are qualitative, so this code identifies a screening service rather than a separate quantitative value for each allergen.
Report 86005 for the multiallergen screen. Medicare pays it through the CLFS at one national amount that applies across states and localities, with no geographic or office/facility adjustment. The 2026 national CLFS amount is $7.97, unchanged from 2020 through 2026. The test is paid only through the CLFS and 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 86005
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 86005. 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 86005 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86005 on the lab fee schedule since 2020
86005 · CLFS 2026 Q4 (current)
$7.97
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.
86005 compared with similar tests
- 86003Allergen IgECrude extract, each allergen$5.22
- 86005 is a qualitative screen across multiple allergens. Code 86003 is allergen-specific IgE testing using crude extract, reported for each allergen.
- 86008Allergen IgERecombinant or purified component$17.93
- Code 86008 tests IgE to individual recombinant allergens; 86005 is a qualitative multiallergen screen.
- 86001Allergen IgGEach allergen$7.82
- Code 86001 measures allergen-specific IgG, not IgE. The codes represent different antibody classes and tests.
86005 billing questions
When should 86005 be used instead of 86003?
Use 86005 for a qualitative screen covering multiple allergens. Code 86003 is for allergen-specific IgE testing using crude extract, reported for each allergen.
Should each allergen in the screen be counted as a separate unit?
No. Report the multiallergen screening service, not a separate 86005 unit for every allergen represented.
Does 86005 report a separate result for each allergen?
It represents a qualitative multiallergen screen, rather than separate allergen-specific testing.
Can 86008 be used for the same kind of screen?
No. Code 86008 is for IgE testing of individual recombinant allergens, rather than a qualitative multiallergen screen.
How does Medicare pay 86005?
Medicare pays the test through the CLFS at one national amount across localities, without an office or facility adjustment. It is excluded from the physician fee schedule.
Is 86001 interchangeable with 86005?
No. Code 86001 measures allergen-specific IgG, while 86005 screens for IgE antibodies; the antibody class and test differ.
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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