Coverage by Test
Medicare coverage rules in plain English, organized by CPT code. Pick a test below for what Medicare covers, when it’s ordered, and what to ask your doctor.
- 85025Complete Blood Count (CBC) with Differential
The standard blood count panel. Covered under NCD 190.15.
- 80053Comprehensive Metabolic Panel (CMP)
14-test metabolic panel. No NCD code restriction — case-by-case medical necessity.
- 80061Lipid Panel
Cholesterol, triglycerides, HDL, LDL. Covered under NCD 190.23.
- 83036Hemoglobin A1c (HbA1c)
3-month average blood sugar. Covered under NCD 190.21.
- 82306Vitamin D, 25-Hydroxy
25-hydroxyvitamin D level. Covered under NCD 190.22 with a specific code list.
- 84153PSA, Total
Prostate-specific antigen. NCD 190.31 (diagnostic) or G0103 (screening).
Looking for a code that’s not in this list? Use Code Lookup to search any CPT.