CPT code 86618: Lyme antibody, lyme disease antibody2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This laboratory assay measures antibodies to Borrelia burgdorferi and is reported when Lyme disease serology is performed.
Medicare pays $17.03 for 86618 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
$17.03
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
- $17.03
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 86618 covers
86618 measures antibodies to Borrelia burgdorferi, the bacterium associated with Lyme disease; it reflects an immune response rather than direct detection of the organism. Clinicians may order serology when symptoms and exposure history raise concern for Lyme disease. Testing is commonly performed on serum in a clinical laboratory, and results are considered with clinical findings because antibodies may take time to develop and can remain detectable after infection.
Report 86618 for the Lyme antibody assay performed. A separately performed confirmatory Lyme antibody test may be reported as 86617 when the testing sequence calls for it. Modifier QW identifies the CLIA-waived version for sites holding a CLIA certificate of waiver. Medicare pays 86618 through the CLFS at one national amount in every locality, with no geographic or office/facility adjustment; the 2026 amount is $17.03, unchanged since 2020. The test is paid only through the CLFS.
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 86618
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 86618. 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 86618 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 86618 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $17.03.
86618 on the lab fee schedule since 2020
86618 · CLFS 2026 Q4 (current)
$17.03
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.
86618 compared with similar tests
- 86617Lyme antibodyConfirmatory assay$15.49
- Use 86618 for the Lyme antibody assay and 86617 when a separate confirmatory Lyme antibody test is performed.
- 86619Borrelia antibodyRelapsing fever target$13.38
- 86618 identifies Lyme disease antibody testing; 86619 is labeled for Borrelia antibody testing.
- 86611Bartonella antibody$10.18
- 86611 reports Bartonella antibody testing, not Lyme antibody testing. Choose according to the organism the laboratory assay targets.
86618 billing questions
How does 86618 differ from 86617?
86618 reports the Lyme antibody assay; 86617 is used for a separately performed confirmatory Lyme antibody test. Select the code that matches the test performed.
Does 86618 include confirmatory testing?
It reports the Lyme antibody assay itself. A separately performed confirmatory test may be reported with 86617 when appropriate to the testing sequence.
When is modifier QW appropriate?
Use QW for the CLIA-waived version when the test is performed by a site holding a CLIA certificate of waiver.
What specimen is typically tested?
The assay is commonly performed on serum.
How does Medicare pay for 86618?
Medicare pays this test through the CLFS at one national amount, without geographic or office/facility variation.
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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