CPT code 86308: Mono test, heterophile antibody screen2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Screens a blood specimen for heterophile antibodies associated with infectious mononucleosis when a patient has a compatible clinical illness.
Medicare pays $5.18 for 86308 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
$5.18
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
- $5.18
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 86308 covers
An office or clinical laboratory uses this blood test to screen for heterophile antibodies associated with infectious mononucleosis. It is commonly ordered when a patient has a compatible illness, such as fever, sore throat, marked fatigue, and cervical lymph-node enlargement. A positive screen supports mono in the right clinical context; it does not test for EBV-specific antibody targets. Office-based point-of-care testing is one setting for this service, while a laboratory may perform the screen on a submitted specimen.
Report one unit for each heterophile antibody screening test performed; do not substitute a titer code when the service is a screen. Modifier QW identifies the CLIA-waived version for sites holding a CLIA certificate of waiver. Medicare pays 86308 only through the CLFS: the 2026 national amount is $5.18, unchanged from 2020 through 2026. The amount is the same across localities, with no office or facility difference. The physician fee schedule excludes the test.
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 86308
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 86308. 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 86308 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 86308 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $5.18.
86308 on the lab fee schedule since 2020
86308 · CLFS 2026 Q4 (current)
$5.18
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.
86308 compared with similar tests
- 86309Mononucleosis titerQuantitative antibody level$6.47
- Use 86308 for a heterophile antibody screen. Use 86309 when the service determines a titer.
- 86310Heterophile titerAfter absorption$7.37
- 86308 reports a heterophile antibody screen; 86310 describes a related heterophile antibody absorption service.
- 86665VCA antibodyEpstein-Barr virus$18.14
- 86308 screens for heterophile antibodies associated with mono. 86665 tests for antibodies to the EBV viral capsid antigen.
86308 billing questions
When should 86308 be reported instead of 86309?
Report 86308 for a heterophile antibody screen. Use 86309 when the service measures a heterophile antibody titer.
When is modifier QW appropriate?
Modifier QW identifies the CLIA-waived version of 86308. Use it when the test is performed at a site holding a CLIA certificate of waiver.
How many units should be reported?
Report one unit for each heterophile antibody screening test performed, rather than counting antibodies or symptoms.
Does Medicare pay 86308 under the physician fee schedule?
No. Medicare pays this test through the CLFS; the physician fee schedule excludes it.
What documentation distinguishes a screen from a titer?
Document whether the ordered and performed service was a heterophile antibody screen or a titer. The screening service is reported with 86308.
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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