Acute Hepatitis Panel Cost and Medicare Coverage (CPT 80074)

Also called: acute viral hepatitis panel · hepatitis panel · acute hepatitis panel with reflex — all the same test, CPT 80074.

National policy — the same Medicare rules apply in every state what's this?

This test is governed by a National Coverage Determination (NCD) — a rule issued by CMS, the federal agency that runs Medicare. It spells out which diagnoses justify the test and any frequency limits, it applies identically in all 50 states, and no regional contractor can override it. What you read on this page is the rule everywhere.

Does Medicare cover it?: Only for certain diagnoses — such as abnormal liver function test results, with or without symptoms, symptoms of liver disease or injury, such as jaundice, before and after a liver transplant (examples only; details below)
You pay if covered: $0 — no deductible, no coinsurance
Medicare pays the lab: $47.63
Information verified: 2026-09-27

Buy it yourself — what you'd really pay

Where	Test price	Fee	Total
Jason Health jasonhealth.com · Quest test 10306, with reflex confirmation	$95	$18 one fee per order — covers every test on it	$113
Ulta Lab Tests ultalabtests.com · Quest test 10306, with reflex confirmation Partner link — we earn a commission if you order. No extra cost to you.	$99.95	$12.95 draw fee — one per order, covers every test on it	$112.90

Disclosure: the Ulta Lab Tests link above is a partner link. If you order through it, ClaraCover earns a commission. It costs you nothing extra, and it never changes what we tell you about Medicare coverage.

The short answer

Covered when your liver tests are abnormal or you have symptoms of liver disease and your doctor needs to know whether a hepatitis virus is the cause. Medicare’s national policy (NCD 190.33, the same in every state) covers the acute hepatitis panel in two situations: “to detect viral hepatitis infection when there are abnormal liver function test results, with or without signs or symptoms of hepatitis,” and “prior to and subsequent to liver transplantation.”

The policy describes the panel as a tool “for differential diagnosis in a patient with symptoms of liver disease or injury,” meaning it is for finding the cause of a liver problem that is already showing. It is not the hepatitis C screening test; that is a separate Medicare benefit with its own rules and its own page.

Two things make this panel’s bill bigger than its code suggests: the policy says that once a diagnosis is made, only the individual tests are needed, not the panel again; and both big labs run “reflex” confirmation tests on positive results, which are billed as separate codes on top of the panel.

What the four tests are

The policy lists the panel’s contents: “Hepatitis A antibody (HAAb), IgM antibody; Hepatitis B core antibody (HBcAb), IgM antibody; Hepatitis B surface antigen (HBsAg) and; Hepatitis C antibody.” Labcorp (test 144000), Quest (test 10306), and Cleveland Clinic Laboratories all list the same four:

Hepatitis A antibody, IgM
Hepatitis B core antibody, IgM
Hepatitis B surface antigen (HBsAg)
Hepatitis C antibody

The policy notes that two other hepatitis B tests, HBeAg and HBeAb, “are not included in the hepatitis panel.” Together the four look for what Cleveland Clinic Laboratories calls “acute viral hepatitis due to HAV, HBV, or HCV,” and Labcorp says the panel “is used to aid in the diagnosis of acute viral hepatitis due to infection with HAV, HBV and/or HCV.”

When Medicare DOES cover it

The national policy’s covered picture, in plain English:

Abnormal liver function tests, with or without symptoms. If a liver enzyme result such as a GGT or the liver lines on a metabolic panel came back abnormal, this panel is the covered next step to check for a viral cause.
Symptoms of liver disease or injury. The policy frames the panel as the differential-diagnosis test for a patient with those symptoms; MedlinePlus lists jaundice, fever, fatigue, dark urine, abdominal pain, and nausea among the reasons hepatitis testing is ordered.
Before and after a liver transplant.
A repeat panel when symptoms continue. “When the time of exposure or the stage of the disease is not known, a patient with continued symptoms of liver disease despite a completely negative hepatitis panel may need a repeat panel approximately 2 weeks to 2 months later to exclude the possibility of hepatitis.”

If one of these genuinely describes your situation, the diagnosis for it belongs on your doctor’s order, and coverage follows.

When Medicare does NOT cover it

The whole panel after the diagnosis is known. The policy’s limitation: “After a hepatitis diagnosis has been established, only individual tests, rather than the entire panel, are needed.” Its description says the same thing from the other direction: “Once a diagnosis is established, specific tests can be used to monitor the course of the disease.” A repeat of all four codes for someone who already knows which virus they have is the claim at risk.
A panel with neither covered reason on the order. The policy names abnormal liver results, symptoms of liver disease, and liver transplant. Checking for hepatitis C in someone with no symptoms and normal liver tests is what the hepatitis C screening benefit is for, and it is billed under a different code with its own limits.
A repeat panel too soon. The policy’s window for a repeat after a negative panel with continuing symptoms is “approximately 2 weeks to 2 months later.”

(Never ask anyone to change a code just to get coverage; that is fraud. But doctors often have a legitimate reason for the test that simply wasn’t written down.)

What you pay if it IS covered: $0

Covered lab tests cost Medicare patients nothing, with no deductible and no 20% coinsurance. Medicare pays the lab $47.63 for the acute hepatitis panel, and you owe zero. Reflex confirmation tests, when a component comes back positive, are billed as their own codes (Quest lists CPT 87341 for the HBsAg confirmation and 87522 for the hepatitis C RNA test); they are separate line items on the bill.

What you pay if it is NOT covered, read this before you sign

Quest’s own test directory flags the acute hepatitis panel as “subject to a Medicare Limited Coverage Policy” that “may require a signed ABN when ordering.” (Labcorp’s page and Cleveland Clinic Laboratories’ catalog entry carry no such notice.) If the panel is on your order without abnormal liver results, liver symptoms, or a transplant behind it, or as a repeat after your diagnosis is already established, expect the Advance Beneficiary Notice (ABN), the signature pad, committing you to the lab’s own billing rates if Medicare denies the claim. Before you sign:

Ask the lab to print exactly what you would owe. You’re entitled to see the number in black and white first. For perspective: when Medicare covers this exact panel, it pays the lab $47.63.
Ask whether reflex tests are included in that figure. Quest’s panel reflexes to confirmation tests “at additional charge”; a positive result adds codes the printed figure may not show.
Know the direct prices: the four-test panel sells for $95 at Jason Health (jasonhealth.com, plus their flat $18 lab-collection fee per order, so $113 all in). The full table is above. Quest’s consumer site, Labcorp OnDemand, and Personalabs sell hepatitis tests one at a time (a hepatitis C test with confirmation is $62 at Quest and $69 at Labcorp), not the panel. Same certified labs, same blood draw.

Before you sign the pad, 60-second checklist

Ask: “Can you print what I’ll owe if Medicare doesn’t pay, including any reflex tests?”
Ask your doctor: “Is this because of an abnormal liver result or symptoms, and is that on the order?”
Compare the printed price to the direct-purchase prices before deciding how to proceed.

What counts as a “normal” acute hepatitis panel result

There is no range for this one. Each of the four tests comes back negative or positive (Quest’s directory says the reference range is “see individual tests,” and Cleveland Clinic Laboratories prints none). MedlinePlus explains what the two answers mean: “A negative or normal result means you probably don’t have a hepatitis infection. But if you know you were exposed to hepatitis, you may need to be tested again later on.” And: “A positive or abnormal result may mean: You have an active hepatitis infection now” or “you had a hepatitis infection in the past that cleared up.”

A positive component is not a diagnosis by itself. Medicare’s policy notes that hepatitis C antibody tests produce false positives and that “positive results usually are confirmed by a more specific technique,” which is what the reflex tests at Labcorp and Quest are for. Your doctor will explain what the next step is.

(Where lab ranges and “optimal” ranges come from, and who decides.)

This page can tell you where those numbers came from. It cannot tell you what yours means; that reading belongs to your doctor, alongside your liver tests and your history.

Quick questions people ask

What is an acute hepatitis panel? One blood draw that checks for hepatitis A, B, and C. MedlinePlus says the most common hepatitis test is a panel that checks all three from one sample, also called an “acute viral hepatitis panel,” and that “generally, hepatitis testing is used to find out if there is any sign of hepatitis in your blood.” On billing paperwork it is CPT code 80074.

What is a “reflex” test, and why does it cost extra? A reflex test is one the lab runs automatically when a component is positive. Quest’s panel reflexes a positive HBsAg to a confirmation test and a positive hepatitis C antibody to an RNA (PCR) test, “at additional charge,” under CPT 87341 and 87522; Labcorp’s hepatitis C antibody reflexes to a quantitative PCR; Cleveland Clinic Laboratories performs and bills an HBsAg confirmation on reactive results. Medicare’s policy describes the same practice for hepatitis C: positive results “usually are confirmed by a more specific technique.”

Is this the same as the hepatitis C screening Medicare covers? No. The hepatitis C screening is a separate preventive benefit for people without symptoms, with its own code and its own rules on who qualifies and how often. The acute panel is a diagnostic test for someone whose liver is already showing a problem, and it covers hepatitis A and B as well.

Do you have to fast for a hepatitis panel? No. MedlinePlus says “you don’t need any special preparations for hepatitis testing,” and Quest’s directory lists none. Labcorp’s page carries one caution: biotin can interfere with the test, and it asks that you stop it 72 hours before the draw. Tell your doctor about any supplement you take.

Why would my doctor repeat the panel a few weeks later? Because the first one can be negative too early. The policy says that when the time of exposure or the stage of disease is not known, a patient with continuing symptoms and a fully negative panel “may need a repeat panel approximately 2 weeks to 2 months later to exclude the possibility of hepatitis.” MedlinePlus says the same: if you know you were exposed, you may need to be tested again later.

Sources and data dates

Medicare payment amount: CMS Clinical Laboratory Fee Schedule, 2026 Q3 file (national rate for 80074). Coverage rules: CMS Medicare Coverage Database, NCD 190.33 (Hepatitis Panel/Acute Hepatitis Panel), a national policy identical in every state, and the same text in the NCD Manual, Chapter 1, Part 3. Test descriptions, components, preparation, and results: MedlinePlus (Hepatitis Testing), Cleveland Clinic Laboratories test catalog, Labcorp test 144000, Quest test 10306. Consumer prices checked September 2026. Information current as of the date shown above; coverage is always determined by Medicare when your claim is processed.

ClaraCover provides information, not medical, billing, or insurance advice. Talk to your doctor about what tests you need.

Covered diagnoses for CPT 80074

Medicare's national rule for this test, NCD 190.33, Hepatitis Panel/Acute Hepatitis Panel, comes with a list of 187 ICD-10 diagnosis codes that support it (CMS's laboratory code list, updated every quarter). In plain English, the covered situations are the ones described on this page: abnormal liver function test results, with or without symptoms; symptoms of liver disease or injury, such as jaundice; before and after a liver transplant. A claim whose diagnosis is on the list pays; a claim without one is denied as not medically necessary unless another provision of the rule applies.

Billing office? The full list, a batch check, and no daily limit are what we are building for you: tell us you want it. For why lab tests are the one place Medicare gives a straight answer, see what "reasonable and necessary" means.