CPT code 86039: ANA, titer measurement2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports an antinuclear antibody titer to assess antibody reactivity during laboratory evaluation of autoimmune disorders.
Medicare pays $11.16 for 86039 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
$11.16
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 86039 covers
Code 86039 identifies an antinuclear antibody (ANA) titer used to assess antibody reactivity during evaluation of autoimmune disorders. The titer reports the ANA result in titer form and distinguishes this service from ANA testing reported without a titer. Clinicians may use the result as part of an autoimmune laboratory workup, and clinical laboratories perform and report it to ordering providers. The result is interpreted with the patient’s clinical findings and other laboratory results.
Report 86039 when an ANA titer is performed. Report 86038 for ANA testing without a titer; report both only when both services are performed. Medicare pays 86039 only under the Clinical Laboratory Fee Schedule (CLFS). The 2026 national CLFS amount is $11.16, unchanged since 2020. One national amount applies in every locality, with no geographic or office-versus-facility adjustment. 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 86039
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 86039. 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 86039 with status X (excluded by statute), so the test itself is paid only from the CLFS.
86039 on the lab fee schedule since 2020
86039 · CLFS 2026 Q4 (current)
$11.16
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.
86039 compared with similar tests
- 86038ANA testScreening$12.09
- Use 86038 for ANA testing without a titer and 86039 for the ANA titer. Both may be reported when both services are performed.
- 86036ANCA screenEach antibody$12.05
- 86036 is an ANCA screening test; 86039 reports an ANA titer. The antibody target distinguishes the tests.
- 86037ANCA titerEach antibody$12.05
- 86037 reports an ANCA titer, while 86039 reports an ANA titer. The antibody target determines the applicable code.
86039 billing questions
How does 86039 differ from 86038?
86038 represents ANA testing without a titer; 86039 reports an ANA titer. Choose the code or codes that match the services performed.
Can 86039 be reported with 86038?
Both may be reported when ANA testing without a titer and titer testing are performed.
What documentation supports reporting the titer?
Keep the test order and laboratory report identifying the ANA titer, along with documentation of the clinical evaluation.
How does Medicare pay 86039?
Medicare pays 86039 through the CLFS at one national amount, without locality or office-versus-facility adjustment. It is excluded from the physician fee schedule.
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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