CPT code 87501: Influenza test, each type or subtype2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Amplified nucleic acid testing for one influenza virus type or subtype, reported when a laboratory evaluates a patient for influenza.
Medicare pays $51.31 for 87501 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
$51.31
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 87501 covers
87501 detects influenza virus genetic material using an amplified-probe method, with reverse transcription when performed. It is reported for one influenza type or subtype. For testing of two or three types or subtypes, 87502 is the corresponding code; 87503 reports each additional type or subtype beyond that group. Molecular laboratories perform and report this testing during evaluation for influenza.
Report 87501 for each type or subtype tested when this code applies. Medicare pays the test through the Clinical Laboratory Fee Schedule (CLFS); the 2026 national amount is $51.31, unchanged since 2020. The same CLFS amount applies across states and localities, with no office-versus-facility difference. Medicare pays this test 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 87501
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 87501. 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 87501 with status X (excluded by statute), so the test itself is paid only from the CLFS.
87501 on the lab fee schedule since 2020
87501 · CLFS 2026 Q4 (current)
$51.31
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.
87501 compared with similar tests
- 87502Influenza NAATFirst two types or subtypes$95.80
- 87501 is for one influenza type or subtype; 87502 is for testing two or three types or subtypes.
- 87503Influenza NAATEach type beyond two$29.22
- 87503 reports each additional influenza type or subtype beyond the two or three represented by 87502; 87501 reports one type or subtype.
- 87631Respiratory virus panelThree to five targets$142.63
- 87631 is for multiplex testing of a broader respiratory pathogen target set, while 87501 detects an influenza type or subtype.
87501 billing questions
How does 87501 differ from 87502?
87501 is for one influenza type or subtype. 87502 is for testing two or three types or subtypes.
When is 87503 reported?
87503 reports each additional influenza type or subtype beyond the two or three represented by 87502.
What should the test documentation identify?
The record should support the influenza testing and identify the type or subtype tested and the number of types or subtypes evaluated.
How does Medicare pay for 87501?
Medicare pays 87501 through the CLFS. The national amount applies across localities and is the same in office and facility settings.
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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