CPT code 87650: Strep A test, direct nucleic-acid probe2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Direct-probe nucleic-acid testing detects group A Streptococcus, typically in a throat specimen when evaluating suspected streptococcal pharyngitis.
Medicare pays $20.05 for 87650 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
$20.05
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
- $20.05
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 87650 covers
Code 87650 identifies group A Streptococcus by direct-probe nucleic-acid detection. It is used when evaluating suspected group A streptococcal pharyngitis; a throat swab is a typical specimen. Unlike an antigen test, it detects nucleic acid, and unlike 87651, it uses a direct-probe rather than amplification method. Clinical laboratories perform the assay; sites holding a CLIA certificate of waiver may perform its CLIA-waived version.
Select the code according to the assay performed: 87650 for direct-probe detection, 87651 for amplification, and 87652 for quantitative group A strep nucleic-acid testing. Modifier QW identifies the CLIA-waived version when performed by a site holding a CLIA certificate of waiver. Medicare pays 87650 only through the CLFS, at one national amount that applies in every state and locality, with no geographic adjustment or office/facility difference. The 2026 national CLFS amount is $20.05, unchanged since 2020. The test is excluded from the physician fee schedule by statute.
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 87650
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 87650. 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 87650 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 87650 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $20.05.
87650 on the lab fee schedule since 2020
87650 · CLFS 2026 Q4 (current)
$20.05
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.
87650 compared with similar tests
- 87651Strep A testAmplified nucleic acid$35.09
- Use 87650 for direct-probe nucleic-acid detection. Use 87651 when the assay amplifies group A strep nucleic acid.
- 87652Group A strep testQuantitative nucleic acid$41.76
- 87652 reports quantitative group A strep nucleic-acid testing; 87650 represents direct-probe detection rather than a quantitative result.
- 87880Rapid strep testGroup A antigen, visual$16.53
- 87880 is used for group A strep antigen detection. Code 87650 is for direct-probe nucleic-acid detection.
- 87653Group B strepAmplified nucleic acid$35.09
- 87653 detects group B Streptococcus by nucleic-acid amplification. Code 87650 is for group A Streptococcus using a direct probe.
87650 billing questions
How does 87650 differ from 87651?
87650 is the direct-probe nucleic-acid test for group A Streptococcus. Use 87651 when the assay amplifies group A strep nucleic acid.
When is modifier QW reported?
QW identifies the CLIA-waived version of this test. It is relevant when the test is performed at a site holding a CLIA certificate of waiver.
What specimen is typically tested?
A throat swab is a typical specimen when evaluating suspected group A streptococcal pharyngitis.
Is 87650 paid under the physician fee schedule?
No. Medicare pays this test only through the CLFS, using one national amount across localities and care settings.
Should 87650 be used for a quantitative Strep A result?
No. 87650 identifies direct-probe detection; 87652 is the code for quantitative group A strep nucleic-acid testing.
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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