CPT code 87490: Chlamydia test, direct DNA probe2026 Medicare lab fee · Clinical Laboratory Fee Schedule
A direct-probe nucleic acid test detects Chlamydia trachomatis and is reported when a laboratory performs this method of testing.
Medicare pays $22.75 for 87490 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
$22.75
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 87490 covers
This assay detects Chlamydia trachomatis nucleic acid using a direct-probe method. Clinical laboratories perform it to identify the organism in submitted specimens and report detection results to ordering clinicians. This is a detection test, not a quantitative measurement. The direct-probe method distinguishes 87490 from amplified detection and quantitative testing for the same organism.
Report 87490 when the laboratory performs direct-probe detection, rather than an amplified or quantitative assay. Medicare pays the test through the CLFS, and the code is excluded from the physician fee schedule. The 2026 national CLFS amount is $22.75, unchanged since 2020. The same amount applies across states and localities, with no geographic adjustment or office-versus-facility difference.
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 87490
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 87490. 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 87490 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87490 on the lab fee schedule since 2020
87490 · CLFS 2026 Q4 (current)
$22.75
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.
87490 compared with similar tests
- 87491Chlamydia testAmplified nucleic acid detection$35.09
- 87490 identifies direct-probe detection of Chlamydia trachomatis; 87491 identifies amplified-probe detection.
- 87492Chlamydia testQuantitative nucleic acid$53.47
- 87490 is a direct-probe detection test. 87492 is used for quantitative testing of Chlamydia trachomatis.
- 87494CT/NG assayMultiplex amplified probe$70.18
- 87490 tests for Chlamydia trachomatis alone by direct probe. 87494 is for a combined chlamydia and gonorrhea multiplex assay.
87490 billing questions
When should 87490 be reported instead of 87491?
Use 87490 when the laboratory performs direct-probe detection of Chlamydia trachomatis. Use 87491 for an amplified-probe test.
Does 87490 report a quantitative result?
No. It identifies direct-probe detection; 87492 is the related quantitative test.
Does Medicare use a different CLFS amount by location or setting?
No. The CLFS amount is national and does not vary by state, locality, or office versus facility setting.
How does 87490 differ from 87494?
87490 is a direct-probe test for Chlamydia trachomatis alone. Use 87494 when the performed test is the combined chlamydia and gonorrhea multiplex assay.
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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