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See a sample rate comparisonHealthcare 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.
| 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 XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80338 |
| Medicaid Fee Schedule | $16.66 median of the 5 states in the free preview · View Medicaid rates for 80338 |
National average reimbursement for CPT 80338 by major payers:

$20.90

$26.69

$1.72

$44.27
Choose a payer to see a sample of rates for CPT 80338.
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
Piedmont Newnan Hospital, Inc.
Piedmont Newnan Hospital Inc
Piedmont Hospital, Inc, Piedmont Hospital
Piedmont Healthcare Inc
Northwest Texas Healthcare System Inc, Northwest Texas Healthcare System
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Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 80338 vs. Other Therapeutic Drug Assays Codes
The CPT 80338 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 80338 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 |
|---|---|---|
| 80336-CPT | Low | Antidepressant Drug Screening, This Screening Measures The Amount Of Antidepressants Present In A Blood Or Urine Sample. |
| 80337-CPT | Low | Antidepressant Drug Screening, This Screening Measures The Amount Of Antidepressants Present In A Blood Or Urine Sample. |
| 80338-CPT | Low | Antidepressant Drug Screening, This Screening Measures The Amount Of Antidepressants Present In A Blood Or Urine Sample. |
| 80345-CPT | Low | Barbiturate Drug Screening, This Test Measures The Amount Of Barbiturates Present In Blood And Urine Samples. Barbiturates Work On The Central Nervous System And Have Been Used As Sleeping Pills. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80338. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80338 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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