CPT code 87389: HIV screen, HIV-1 antigen plus HIV-1/2 antibodies2026 Medicare lab fee · Clinical Laboratory Fee Schedule
This immunoassay detects HIV-1 antigen and HIV-1 and HIV-2 antibodies in one combined result for HIV screening.
Medicare pays $24.08 for 87389 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
$24.08
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
- $24.08
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 87389 covers
87389 identifies an immunoassay that detects HIV-1 antigen together with antibodies to HIV-1 and HIV-2. It is used for HIV screening and produces one combined result rather than separately reported results for each target. It differs from HIV-1 antigen-only testing and antibody-only testing. Laboratories perform and report the assay in clinical testing workflows.
Report the assay as a combined test result. For the CLIA-waived version, modifier QW applies when performed by a site holding a CLIA certificate of waiver. Medicare pays 87389 under the CLFS at one national amount, with no geographic adjustment or office-versus-facility difference. The 2026 national CLFS amount is $24.08, unchanged since 2020. The test is paid only from 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 87389
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 87389. 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 87389 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 87389 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $24.08.
87389 on the lab fee schedule since 2020
87389 · CLFS 2026 Q4 (current)
$24.08
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.
87389 compared with similar tests
- 87390HIV-1 antigenAntigen only$24.06
- 87390 detects HIV-1 antigen alone. Use 87389 for the combined HIV-1 antigen and HIV-1/HIV-2 antibody assay.
- 87391HIV antigenHIV-2 antigen detection$21.90
- 87391 detects HIV-2 antigen alone; 87389 combines HIV-1 antigen detection with HIV-1 and HIV-2 antibody detection.
- 86703HIV antibodyCombined, single result$13.71
- 86703 tests for HIV-1 and HIV-2 antibodies without the HIV-1 antigen component included in 87389.
- 87806HIV screenVisual antigen and dual antibody$32.77
- 87806 describes rapid HIV antigen-and-antibody testing using direct optical observation. Code 87389 identifies the combined immunoassay.
87389 billing questions
When should 87389 be selected instead of an HIV antibody-only test?
Use 87389 when the assay detects HIV-1 antigen along with HIV-1 and HIV-2 antibodies. An antibody-only assay does not include the HIV-1 antigen target.
Does 87389 report separate results for each target?
No. It represents a combined result for HIV-1 antigen and HIV-1 and HIV-2 antibodies.
When is modifier QW appropriate?
Use QW for the CLIA-waived version when it is performed by a site holding a CLIA certificate of waiver.
Does Medicare pay 87389 under the physician fee schedule?
No. Medicare pays this test under the CLFS at one national amount, without a geographic or office-versus-facility adjustment.
How does 87389 differ from the rapid HIV antigen-and-antibody test?
87389 identifies the combined immunoassay. Code 87806 identifies the rapid version using direct optical observation.
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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