CPT code 87502: Influenza NAAT, first two types or subtypes2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Multiplex influenza nucleic acid testing detects multiple viral types or subtypes and is reported when evaluating suspected influenza.
Medicare pays $95.80 for 87502 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
$95.80
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
- $95.80
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 87502 covers
This assay detects influenza viral nucleic acid across multiple types or subtypes with a multiplex amplified-probe method; reverse transcription may be part of the process. It is used in evaluating suspected influenza when testing covers multiple influenza types or subtypes. The molecular method distinguishes this test from influenza antigen testing. Within this code family, 87502 covers the first two types or subtypes, while 87501 is for one type or subtype and 87503 captures additional types or subtypes beyond the first two.
Report 87502 for the first two types or subtypes and 87503 for each additional type or subtype. Modifier QW identifies the CLIA-waived version for sites holding a CLIA certificate of waiver. Medicare pays 87502 under the CLFS at one national amount across states and localities, without an office or facility adjustment. The 2026 national amount is $95.80, unchanged from 2020 through 2026. Medicare pays the test only from the CLFS, not the physician fee schedule.
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 87502
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 87502. 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 87502 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 87502 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $95.80.
87502 on the lab fee schedule since 2020
87502 · CLFS 2026 Q4 (current)
$95.80
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.
87502 compared with similar tests
- 87501Influenza testEach type or subtype$51.31
- 87501 is for one influenza type or subtype. 87502 covers the first two types or subtypes in a multiplex test.
- 87503Influenza NAATEach type beyond two$29.22
- 87503 reports each additional influenza type or subtype beyond the first two covered by 87502; it is an add-on code.
- 87804Influenza assayDirect visual immunoassay$16.55
- 87804 detects influenza antigen, whereas 87502 detects influenza nucleic acid using a multiplex amplified-probe method.
- 87637Respiratory testSARS-CoV-2, flu, and RSV$142.63
- 87637 tests for SARS-CoV-2, influenza A and B, and respiratory syncytial virus together; 87502 tests for multiple influenza types or subtypes.
87502 billing questions
When should 87502 be used instead of 87501?
Use 87502 for influenza testing covering the first two types or subtypes. Code 87501 is for one type or subtype.
How are additional influenza types or subtypes reported?
Report 87503 for each additional type or subtype beyond the first two represented by 87502.
When is modifier QW appropriate?
CMS lists a CLIA-waived version of 87502. Use QW for that version when it is performed by a site holding a CLIA certificate of waiver.
How does Medicare pay for 87502?
Medicare pays 87502 under the CLFS using one national amount across states and localities, with no office or facility adjustment.
How does 87502 differ from an influenza antigen test?
87502 detects influenza nucleic acid using a multiplex amplified-probe method. An antigen test such as 87804 detects viral antigen by a different method.
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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