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See a sample rate comparisonCPT 80343 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.
Antipsychotic Drug Screening, This Screening Measures The Amount Of Antipsychotics Present In A Blood Or Urine Sample.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Therapeutic Drug Assays |
| Common Place of Service | 81 - Independent Laboratory 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 90 - Reference Laboratory 59 - Distinct Procedural Service 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80343 |
| Medicaid Fee Schedule | $15.75 median of the 5 states in the free preview · View Medicaid rates for 80343 |
National average reimbursement for CPT 80343 by major payers:
$35.94
$34.64
$3.64
$55.61
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CPT 80343
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$32.33Published rateClhg-Acadian, LLC, Acadian Medical Center
$19.06Published ratePointe Coupee Parish Health Services District Number One, Pointe Coupee General Hospital
$19.06Published ratePiedmont Athens Regional Medical Center, Inc.
Piedmont Athens Regional Medical Center Inc
$19.06Published rateUhs Of Texoma, Inc, Texoma Medical Center
Uhs Of Texoma Inc
$8.89Published rate
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See a sample payer proposalCPT 80343 vs. Other Therapeutic Drug Assays Codes
The CPT 80343 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 80343 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 |
|---|---|---|
| 80341-CPT | Low | Antiepileptic Drug Screening, This Screening Measures The Amount Of Antiepileptics Present In A Blood Or Urine Sample. |
| 80342-CPT | Low | Antipsychotic Drug Screening, This Screening Measures The Amount Of Antipsychotics Present In A Blood Or Urine Sample. |
| 80343-CPT | Low | Antipsychotic Drug Screening, This Screening Measures The Amount Of Antipsychotics Present In A Blood Or Urine Sample. |
| 80344-CPT | Low | Antipsychotic Drug Screening, This Screening Measures The Amount Of Antipsychotics Present In A Blood Or Urine Sample. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80343. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80343 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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