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See a sample rate comparisonCPT 80360 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.
Methylphenidate Drug Screening, This Test Measures The Amount Of Methylphenidate Present In Blood And Urine Samples.
| 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 TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 80360 |
| Medicaid Fee Schedule | $19.20 median of the 5 states in the free preview · View Medicaid rates for 80360 |
National average reimbursement for CPT 80360 by major payers:
$20.86
$14.42
$1.98
$48.56
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CPT 80360
5 of 25 sample ratesHigher to lower in this preview
Chu Chen
Merrimack Valley Pediatric Associates, Inc.
$63.36Published rateChristopher Raio
Mercy Medical Center
$17.61Published rateEyecare Associates PC
$10.39Published rateBama Heart Doc, P.C., Alabama Heart And Vascular Medicine
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$10.15Published rateE And A Medical On The Go Healthcare Of South Florida LLC, E And A Healthcare On The Go
E And A Medical On The Go Healthcare Of South Florida LLC
$8.52Published rate
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See a sample payer proposalCPT 80360 vs. Other Therapeutic Drug Assays Codes
The CPT 80360 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 80360 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 |
|---|---|---|
| 80353-CPT | Low | Cocaine Drug Screening, The Test Measures The Amount Of Cocaine In A Blood Or Urine Sample. |
| 80357-CPT | Low | Ketamine Drug Screening, This Test Measures The Amount Of Ketamine Present In Blood And Urine Samples. |
| 80360-CPT | Low | Methylphenidate Drug Screening, This Test Measures The Amount Of Methylphenidate Present In Blood And Urine Samples. |
| 80372-CPT | Low | Tapentadol Drug Screening, This Test Measures The Amount Of Tapentadol Present In Blood And Urine Samples. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 80360. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 80360 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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