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See a sample rate comparisonCPT 80321 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.
Alcohol Screening, Screening For Alcohol By-Products To Determine Alcohol Use Or Relapse Or Screening To Determine Genetic Disposition To Alcoholism.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Therapeutic Drug Assays |
| Common Place of Service | 81 - Independent Laboratory 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component 90 - Reference Laboratory |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80321 |
| Medicaid Fee Schedule | $13.705 median of the 6 states in the free preview · View Medicaid rates for 80321 |
National average reimbursement for CPT 80321 by major payers:
$26.44
$20.61
$2.13
$45.34
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CPT 80321
5 of 25 sample ratesHigher to lower in this preview
Covenant Medical Center
$17.63Published rateClhg-Ville Platte LLC, Mercy Regional Medical Center
$13.22Published rateClhg-Ville Platte LLC, Mercy Regional Medical Center
$13.22Published rateTouro Infirmary
$8.81Published rateUhs Of Texoma, Inc, Texoma Medical Center
Uhs Of Texoma Inc
$6.17Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 80321 vs. Other Therapeutic Drug Assays Codes
The CPT 80321 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 80321 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 |
|---|---|---|
| 80306-CPT | Low | Drug Test(S) Presumptive Any Number Of Drug Classes Any Number Of Devices Or Procedures; Read By Instrument Assisted Direct Optical Observation (Eg Utilizing Immunoassay [Eg Dipsticks Cups Cards Or Cartridges]) Includes Sample Validation When Performed Per Date Of Service (Desc Revised 1/1/2018) |
| 80307-CPT | Low | Drug Test Prsmv Chem Anlyzr, Drug Test S Presumptive Any Number Of Drug Classes Any Number Of Devices Or Procedures By Instrument Chemistry Analyzers Eg Utilizing Immunoassay Eg Eia Elisa Emit Fpia Ia Kims Ria Chromatography Eg Gc Hplc And Mass Spectrometry Either With Or Without Chromatography Eg Dart Desi Gc Ms Gc Ms Ms Lc Ms Lc Ms Ms Ldtd Maldi Tof Includes Sample Validation When Performed Per Date Of Service |
| 80320-CPT | Low | Pathology And Laboratory, Drug Screen Quantitative Alcohols |
| 80321-CPT | Low | Alcohol Screening, Screening For Alcohol By-Products To Determine Alcohol Use Or Relapse Or Screening To Determine Genetic Disposition To Alcoholism. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80321. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80321 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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