CPT code 87390: HIV-1 antigen, antigen only2026 Medicare lab fee · Clinical Laboratory Fee Schedule
HIV-1 antigen immunoassay detects antigen alone and is reported for qualitative or semiquantitative laboratory testing, not combined antigen-antibody testing.
Medicare pays $24.06 for 87390 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
$24.06
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 87390 covers
This immunoassay detects HIV-1 antigen and may produce a qualitative or semiquantitative result. Report it for a laboratory-performed HIV-1 antigen assay, rather than an assay that also detects HIV-1 and HIV-2 antibodies. The code identifies antigen detection, not an antibody-only assay.
Report 87390 for the HIV-1 antigen immunoassay performed; use 87389 for a combined HIV-1 antigen and HIV-1/HIV-2 antibody assay. Medicare pays 87390 only through the Clinical Laboratory Fee Schedule (CLFS). The 2026 national CLFS amount is $24.06, unchanged since 2020. One amount applies in every state and locality, with no geographic or office-versus-facility adjustment.
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 87390
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 87390. 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 87390 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87390 on the lab fee schedule since 2020
87390 · CLFS 2026 Q4 (current)
$24.06
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.
87390 compared with similar tests
- 87389HIV screenHIV-1 antigen plus HIV-1/2 antibodies$24.08
- Choose 87389 for the combined HIV-1 antigen and HIV-1/HIV-2 antibody assay. Choose 87390 when the performed assay detects HIV-1 antigen alone.
- 87391HIV antigenHIV-2 antigen detection$21.90
- 87391 detects HIV-2 antigen; 87390 detects HIV-1 antigen.
- 86701HIV-1 antibodyHIV-1-specific antibody$8.89
- 86701 is for HIV-1 antibody testing. Code 87390 is for HIV-1 antigen detection.
- 86703HIV antibodyCombined, single result$13.71
- 86703 is for HIV-1 and HIV-2 antibody testing, not an HIV-1 antigen-only assay.
87390 billing questions
How does 87390 differ from 87389?
87390 is for HIV-1 antigen detection alone. Use 87389 when the performed assay combines HIV-1 antigen detection with HIV-1 and HIV-2 antibody detection.
Is this an HIV antibody test?
No. This code describes an immunoassay for HIV-1 antigen; HIV antibody testing is represented by different codes.
When should 87391 be used instead?
87391 is the corresponding antigen test for HIV-2. Select the code that matches the antigen the laboratory tested.
How does Medicare pay for 87390?
Medicare pays 87390 through the CLFS only. The same national amount applies across localities and office or facility settings.
Can 87390 be reported for an HIV-1 antibody assay?
No. Report 87390 only when the service performed is HIV-1 antigen detection by immunoassay; antibody-only testing uses an antibody test code.
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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