CPT code 87651: Strep A test, amplified nucleic acid2026 Medicare lab fee · Clinical Laboratory Fee Schedule
An amplified nucleic acid test detects group A Streptococcus, commonly in a throat specimen when evaluating suspected streptococcal pharyngitis.
Medicare pays $35.09 for 87651 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
$35.09
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
- $35.09
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 87651 covers
This laboratory test detects group A Streptococcus by amplifying its nucleic acid. It is commonly ordered on a throat specimen when a patient has symptoms of acute pharyngitis and the clinician is evaluating for strep throat. Hospital and independent laboratories may perform the assay; a CLIA-waived version may also be performed by a site holding a CLIA certificate of waiver.
Report the code for the amplified group A Streptococcus assay, rather than for a direct-probe test or an assay targeting group B Streptococcus. CMS lists modifier QW for the CLIA-waived version. Medicare pays the test only under the CLFS, at one national amount across states and localities, with no office or facility difference. The 2026 national CLFS amount is $35.09, unchanged since 2020.
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 87651
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 87651. 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 87651 with status X (excluded by statute), so the test itself is paid only from the CLFS.
CLIA-waived version (QW)
CMS also lists 87651 with modifier QW, the version labs holding a CLIA certificate of waiver bill. It pays $35.09.
87651 on the lab fee schedule since 2020
87651 · CLFS 2026 Q4 (current)
$35.09
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.
87651 compared with similar tests
- 87650Strep A testDirect nucleic-acid probe$20.05
- Both target group A Streptococcus, but 87651 is for an amplified nucleic acid assay and 87650 is for a direct-probe assay.
- 87652Group A strep testQuantitative nucleic acid$41.76
- This code is for amplified detection of group A Streptococcus; 87652 is the quantitative nucleic acid test in the same code family.
- 87653Group B strepAmplified nucleic acid$35.09
- 87651 targets group A Streptococcus. Code 87653 targets group B Streptococcus.
- 87880Rapid strep testGroup A antigen, visual$16.53
- Use 87651 for amplified nucleic acid detection. Code 87880 identifies group A Streptococcus antigen detection by immunoassay.
87651 billing questions
How does this differ from code 87650?
Both detect group A Streptococcus using nucleic acid methods. Code 87651 is for an amplified assay; 87650 is for a direct-probe assay.
When should code 87653 be used instead?
Code 87653 targets group B Streptococcus. Use 87651 for an amplified nucleic acid test targeting group A Streptococcus.
When is modifier QW appropriate?
CMS lists QW for the CLIA-waived version. It identifies testing performed under a CLIA certificate of waiver.
How does Medicare pay for this test?
Medicare pays it under the CLFS, not the physician fee schedule. The national CLFS amount applies across localities and does not vary by office or facility setting.
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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