Medicare Reimbursement for Blood Specimen Collection

Medicare and most insurance companies reimburse for specimen collection. Note that Medicare does not cover fingerstick blood collection, but other insurnace companies cover both fingerstick and venipuncure.

Coverage for Specimen Collection

CPT Code    When to Use    Description

G0001    Medicare Claims    Venipuncture
36415    All other insurance claims    Venipuncture
36416    All other insurance claims    Capillary blood specimen (e.g. fingerstick, heal, earstick)


Billing for A1C Testing Including Office visit and specimen collection - Medicare Example
   Most A1C testing can justify both an office visit and a specimen collection fee.

Example :

A patient who is takin medication and has an A1C test performed would be coded as follows:

                                                               CPT Code    Venipuncture       Fingerstick
Non physician office visit                      99211           $20.00                          $20.00
A1C test                                            83036-QW          $13.56                          $13.56
Venipuncture                                             G0001           $3.00    
Total                                                                                $36.56                         $33.56