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See a sample rate comparisonCPT 86701 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.
Hiv Screening Test, This Test Detects Antibodies To Hiv (Aids Virus) Type 1 Type 2 Or Both. It Is Used To Screen For Hiv Infection.
| Key Fact | Detail |
|---|---|
| Service Type | Pathology and Laboratory Procedures Immunology Procedures |
| Common Place of Service | 81 - Independent Laboratory 11 - Office |
| Common Modifiers | 59 - Distinct Procedural Service QW - CLIA Waived Tests |
| Complexity Level | Low |
| Medicare Fee Schedule | $8.89 national lab fee schedule rate (2026) · View Medicare rates for 86701 |
| Medicaid Fee Schedule | $8.18 median of the 8 states in the free preview · View Medicaid rates for 86701 |
National average reimbursement for CPT 86701 by major payers:
$8.19
$10.64
$10.21
$13.18
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CPT 86701
5 of 25 sample ratesHigher to lower in this preview
Amarillo Vamc
$12.40Published rateVhs Brownsville Hospital Company LLC, Valley Baptist Medical Center - Brownsville
$8.89Published rateJackson Parish Hospital, Jackson Parish Hospital
$8.89Published ratePrisma Health-Upstate, Prisma Health Op Surgery Patewood
Prisma Health - Upstate
$8.00Published rateMethodist Hospital Plainview Texas, Covenant Hospital Plainview
Methodist Hospital Plainview Texas
$4.15Published rate
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See a sample payer proposalCPT 86701 vs. Other Immunology Procedures Codes
The CPT 86701 code is part of the Pathology and Laboratory Procedures services used for Immunology Procedures. 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 86701 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 |
|---|---|---|
| 86687-CPT | Low | Test For T-Cell Leukemia, This Blood Test Detects Infection With Human T-Cell Leukemia I Virus. It Also Is Used To Screen Blood And Blood Products Prior To Transfusion. |
| 86701-CPT | Low | Hiv Screening Test, This Test Detects Antibodies To Hiv (Aids Virus) Type 1 Type 2 Or Both. It Is Used To Screen For Hiv Infection. |
| 86702-CPT | Low | Hiv Screening Test, This Test Detects Antibodies To Hiv (Aids Virus) Type 1 Type 2 Or Both. It Is Used To Screen For Hiv Infection. |
| 86703-CPT | Low | Hiv Screening Test, This Test Detects Antibodies To Hiv (Aids Virus) Type 1 Type 2 Or Both. It Is Used To Screen For Hiv Infection. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 86701. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 86701 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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