HCPCS code G0481: Definitive drug test, 8–14 drug classes2026 Medicare lab fee · Clinical Laboratory Fee Schedule
Reports definitive drug identification across 8–14 drug classes in a specimen, often for medication monitoring or evaluation of substance use.
Medicare pays $156.59 for G0481 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
$156.59
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 G0481 covers
G0481 describes definitive testing that identifies individual drugs and can distinguish structural isomers. Laboratories use methods such as gas or liquid chromatography with mass spectrometry, supported by stable internal standards in all samples, method- or drug-specific calibration, and matrix-matched quality controls. Testing may be qualitative or quantitative and may use specimens from any source; urine is common in medication monitoring and substance-use care. The service can support clinical decisions when a more specific result than a presumptive screen is needed.
Report one service per day for testing across 8–14 drug classes; metabolites count when tested. The code includes specimen-validity testing. Medicare pays G0481 through the CLFS only. The 2026 national CLFS amount is $156.59, unchanged since 2020; the same amount applies across localities, without geographic or office/facility adjustment.
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 G0481
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 G0481. 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 G0481 with status X (excluded by statute), so the test itself is paid only from the CLFS.
G0481 on the lab fee schedule since 2020
G0481 · CLFS 2026 Q4 (current)
$156.59
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.
G0481 compared with similar tests
- G0480Definitive drug testOne to seven classes$114.43
- Both report definitive drug testing, but G0480 applies to 1–7 classes; use G0481 for 8–14.
- G0482Definitive drug test15 to 21 classes$198.74
- Both report definitive drug testing, but G0482 applies to 15–21 classes; use G0481 for 8–14.
- 80307Drug screenChemistry analyzer$62.14
- 80307 describes presumptive drug testing. G0481 is for definitive identification across 8–14 drug classes.
G0481 billing questions
How is the 8–14 class range counted?
The range refers to drug classes tested, not simply the number of individual analytes. Include metabolites when performed.
How many units should be reported?
G0481 is reported per day. The code encompasses the definitive testing and specimen-validity testing for that day.
When should G0481 be selected instead of a presumptive drug test?
Use G0481 for definitive identification across 8–14 classes. A presumptive test such as 80307 is a different testing service.
How does G0481 differ from G0480 or G0482?
These are definitive-testing codes distinguished by the number of drug classes: G0480 covers 1–7, G0481 covers 8–14, and G0482 covers 15–21.
Does Medicare pay G0481 under the physician fee schedule?
No. Medicare pays this test through the CLFS only, at one national amount that applies in every locality.
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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