HCPCS code G0471: Specimen collection, SNF or home health2026 Medicare lab fee · Clinical Laboratory Fee Schedule
G0471 reports venous blood collection by venipuncture or catheterized urine collection in a skilled nursing facility or through a laboratory serving a home health agency.
Medicare pays $11.34 for G0471 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
$11.34
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
- +126.8%
- 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 G0471 covers
G0471 covers collection of venous blood by venipuncture or urine by catheterization from an individual in a skilled nursing facility, and collection by a laboratory on behalf of a home health agency. It describes obtaining a specimen rather than analyzing it; the laboratory reports the ordered blood or urine test separately. The qualifying setting or home health arrangement distinguishes this service from routine specimen collection elsewhere.
Medicare pays G0471 under the Clinical Laboratory Fee Schedule (CLFS), not the physician fee schedule. The 2026 national CLFS amount is $11.34. CMS sets one amount across states and localities, with no office-versus-facility adjustment; the amount increased from $5.00 in 2022 to $11.34 in 2026. Report the collection service separately from the laboratory test performed on the specimen.
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 G0471
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 G0471. 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 G0471 with status X (excluded by statute), so the test itself is paid only from the CLFS.
G0471 on the lab fee schedule since 2020
G0471 · CLFS 2026 Q4 (current)
$11.34
Up 126.8% from $5.00 in 2020
Every change on file
- Jan 1, 2026 · CLFS 2026 Q1$11.09 → $11.34 (+2.3%)
- Jan 1, 2025 · CLFS 2025 Q1$10.83 → $11.09 (+2.4%)
- Jan 1, 2024 · CLFS 2024 Q1$10.57 → $10.83 (+2.5%)
- Jan 1, 2023 · CLFS 2023 Q1$5.00 → $10.57 (+111.4%)
27 quarterly CLFS releases on file, first CLFS 2020 Q1. A code missing from a quarter wasn’t on that release.
G0471 compared with similar tests
- 36415VenipunctureRoutine venous sample$9.34
- CPT 36415 reports routine venous blood collection. G0471 applies to venous or catheterized urine collection in its qualifying SNF or HHA context.
- 36416Capillary collectionSkin punctureNo national amount
- CPT 36416 describes capillary blood collection. G0471 covers venous blood by venipuncture or catheterized urine collection in its specified settings.
G0471 billing questions
When should a biller choose G0471 instead of 36415?
G0471 applies to venous blood or catheterized urine collection in a qualifying SNF or HHA arrangement. CPT 36415 reports routine venipuncture.
Can G0471 represent either blood or urine collection?
Yes. It covers venous blood obtained by venipuncture or a urine specimen obtained by catheterization in the qualifying SNF or home health context.
Does G0471 include the laboratory test?
No. G0471 reports specimen collection; the laboratory reports the ordered analysis separately.
What should documentation support?
Document the qualifying SNF or home health context, the specimen collected, and the collection method.
How does Medicare pay G0471?
Medicare pays it under the CLFS at one national amount across localities, with no office-versus-facility payment difference. It is excluded from the physician fee schedule.
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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