FOBT Stool Test Cost and Medicare Coverage (CPT 82274)
Also called: FIT test · stool blood test · hemoccult test · guaiac test — all the same test, CPT 82274 (related code: 82272).
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?
- Yes — with frequency limits
- You pay if covered
- $0 — no deductible, no coinsurance
- Medicare pays the lab
- $15.92
- Information verified
- 2026-09-17
Buy it yourself — what you'd really pay
| Where | Test price | Fee | Total |
|---|---|---|---|
| Ulta Lab Tests ultalabtests.com · InSure FIT kit Partner link — we earn a commission if you order. No extra cost to you. | $52.95 | $12.95 Ulta calls it a draw fee — charged on every order, even this mail-in kit | $65.90 |
| Jason Health jasonhealth.com · InSure FIT kit | $80 | $18 one fee per order — covers every test on it | $98 |
| Quest questhealth.com · FIT colorectal screening kit | $79 | $6 physician service fee | $85 |
| Personalabs personalabs.com · price includes the draw; not a partner — we earn nothing from this row | $126 | — | $126 |
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
Yes — once every 12 months from age 45, free, no colonoscopy required. The fecal occult blood test is the no-prep, at-home door into Medicare’s colorectal cancer screening benefit: your doctor gives you a small kit, you return a sample, and the lab checks for hidden blood. And the benefit has a feature almost nobody knows: if the result is positive, the follow-up colonoscopy is also covered as a free screening — the 2023 rule change closed what used to be a notorious surprise-bill gap.
When Medicare DOES cover it
- Age 45 and up: one screening FOBT every 12 months, at $0. (On Medicare paperwork the screening version may appear as code G0328 — same test, screening label.)
- Positive result? The follow-up colonoscopy is covered as part of the screening — not billed as a diagnostic procedure with cost-sharing.
- FOBT is one of several covered colorectal screening options (colonoscopy every 10 years, stool-DNA tests every 3 years, and others) — using a different method resets different clocks, so tell your doctor what you’ve had done.
- Diagnostic use — checking for hidden blood when anemia or symptoms are being worked up — follows ordinary medical-necessity rules any time, under its own national policy.
When Medicare does NOT cover it
- A second screening within the 12-month window — the calendar is the rule.
- Under 45 without symptoms (diagnostic use is separate).
What you pay if it IS covered: $0
No deductible, no coinsurance. Medicare pays the lab about $16–$18 depending on how it’s billed, and you owe zero — including, since 2023, the follow-up colonoscopy after a positive screen.
What it costs to buy yourself
Here the covered route wins decisively: DTC kits run $79 at Quest’s consumer site (questhealth.com, plus a $6 physician fee) and $80 at Jason Health (jasonhealth.com, plus their flat $18 per-order fee) — Labcorp OnDemand doesn’t sell one. Compare that to $0 every 12 months through your doctor: this is the rare page where our advice is simply use the benefit.
What counts as a “normal” FOBT result
There is no range for this one. A fecal occult blood test does not produce a number to compare against a range. The result is negative (no blood detected) or positive (blood detected).
A positive screening result is not a diagnosis. It means the test found something that needs following up with a further test, and your doctor will explain what that 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 history and your other results.
Quick questions people ask
What is a stool guaiac (hemoccult) test? The older chemistry version of this screening: guaiac paper changes color when blood is present. Most labs have moved to the FIT (fecal immunochemical test — this page’s CPT 82274), which detects human blood protein directly, needs only one sample, and isn’t fooled by food. If your kit says Hemoccult or guaiac, it’s the older type — both count as covered FOBT screening.
What foods can cause a false-positive occult blood test? With the old guaiac kits: red meat, certain raw vegetables (horseradish, turnips, broccoli), and vitamin C interference — kits came with diet instructions for a reason. The modern FIT test isn’t affected by diet, which is one more reason labs switched. Follow whatever instructions come with your specific kit.
How often will Medicare pay for it? Once every 12 months from age 45, at $0 — and the frequency question is the whole rule. If a year hasn’t passed since your last covered FOBT, you’re early, not ineligible.
Do you have to fast for a fecal occult blood test? No. It’s a stool sample, not a blood draw, so fasting doesn’t apply. The kit may ask you to avoid certain foods or medicines for a few days first, because some can cause a false positive. Follow the kit’s instructions. (For blood tests, see our fasting guide.)
Sources and data dates
Screening rules: medicare.gov, “Fecal occult blood tests (screening)” — once every 12 months at 45+, with the follow-up colonoscopy covered after a positive result; CMS NCD 210.3. Diagnostic use: NCD 190.34. Medicare payment amounts: CMS Clinical Laboratory Fee Schedule, 2026 Q3 file (82274 and G0328). 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 82274
There is no national diagnosis list for CPT 82274. Coverage follows the general "reasonable and necessary" standard and any local coverage determination your Medicare contractor has written, as this page describes; the diagnosis on the order still has to support the test.
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.