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See a sample rate comparisonCPT 80189 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Itraconazole Monitoring, This Test Measures The Therapeutic Level Of Itraconazole A Drug That Is Typically Used To Treat A Fungal Infection.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Therapeutic Drug Assays |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 90 - Reference Laboratory 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $27.11 national lab fee schedule rate (2026) · View Medicare rates for 80189 |
| Medicaid Fee Schedule | $24.94 median of the 8 states in the free preview · View Medicaid rates for 80189 |
National average reimbursement for CPT 80189 by major payers:
$21.19
$16.31
$28.48
$59.91
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CPT 80189
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$59.64Published rateChristopher Raio
St Joseph Hospital
$35.79Published rateNicole Schwab
Allergy & Asthma Of Dupage, S.C.
$21.69Published rateChristopher Raio
Mercy Medical Center
$14.64Published rateSunrise Home Health Care Inc.
Sunrise Home Health Care Inc
$10.84Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 80189 vs. Other Therapeutic Drug Assays Codes
The CPT 80189 code is part of the Pathology and Laboratory Procedures services used for Therapeutic Drug Assays. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 80189 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 80181-CPT | Low | Flecainide Monitoring, This Test Measures The Therapeutic Level Of Flecainide Present In Blood And Urine Samples. Flecainide Is Typically Used To Prevent And Treat Abnormally Fast Heart Rates. |
| 80183-CPT | Low | Medication Monitoring, Oxcarbazepine Typically Is Used To Treat Seizures Caused By Epilepsy. Periodic Monitoring Evaluates Dosage Adverse Effects And Interactions With Other Drugs. |
| 80187-CPT | Low | Posaconazole, A Lab Test For Posaconazole. This Drug Is Typically Used To Treat Or Prevent Fungal Infections. |
| 80189-CPT | Low | Itraconazole Monitoring, This Test Measures The Therapeutic Level Of Itraconazole A Drug That Is Typically Used To Treat A Fungal Infection. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80189. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80189 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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