Folate Test Cost and Medicare Coverage (CPT 82746)

Also called: folic acid test · vitamin B9 test · serum folate — all the same test, CPT 82746.

The short answer

Only when a folate deficiency is genuinely suspected — the same regional vitamin rules that govern B12. Folate testing lives under the same policies as its constant companion, the B12 test: a targeted test backed by findings is covered; a vitamin panel or “check my levels” order is treated as screening and denied. Since the two tests are so often ordered together, one uncovered line can put a signature pad in front of an otherwise covered blood draw — which is exactly why folate sits in our most-denied group. (What a folate test shows, and what causes low folate.)

When Medicare DOES cover it

The covered picture (from one regional policy, LCD L34914):

• Unexplained anemia — especially with enlarged red blood cells on a CBC, the classic folate/B12 signature
• Malabsorption conditions — celiac disease, Crohn’s, and intestinal surgery histories
• Alcohol-related malnutrition — folate is the vitamin alcohol depletes fastest
• Certain medications that interfere with folate (methotrexate and some seizure medicines are the familiar ones)
• Monitoring a diagnosed deficiency — confirming treatment worked, then roughly annually; policies commonly allow up to about 4 tests a year for active deficiency or malabsorption

When Medicare does NOT cover it

• Routine screening and multi-vitamin wellness panels — categorically treated as screening, never covered
• Riding along on a B12 order without its own justification — each test needs the diagnosis to support it

If your test gets flagged, ask your doctor whether a finding on the covered list genuinely describes your situation. (Never ask anyone to change a code just to get coverage — that’s fraud. But doctors often have a legitimate reason for the test that simply wasn’t coded.)

What you pay if it IS covered: $0

Covered lab tests cost Medicare patients nothing — no deductible, no 20% coinsurance. Medicare pays the lab $14.70, and you owe zero.

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

1. Ask the lab to print exactly what you would owe. You’re entitled to the number in black and white first. For perspective: when Medicare covers this exact test, it pays the lab $14.70.
2. Know the direct prices: $20 at Jason Health (jasonhealth.com — add their flat $18 lab-collection fee per order), $65 at Quest’s consumer site (questhealth.com, plus a $6 physician fee), and $89 at Labcorp OnDemand (sold only bundled with B12). Same certified labs, same blood draw.

Before you sign the pad — 60-second checklist

1. Ask: “Can you print what I’ll owe if Medicare doesn’t pay?”
2. Ask your doctor: “Does my blood work or history make this test medically necessary — for folate specifically?”
3. Compare the printed price to the direct-purchase prices before deciding.

What counts as a “normal” folate level

Start with the range printed on your own report. The National Library of Medicine is direct about why: “normal value ranges may vary slightly among different labs. Talk to your provider about the meaning of your test results.”

There is no national folate cut-off of the kind that exists for blood sugar or cholesterol. Folate is also usually read as a pair with B12, because the two produce a similar picture in the blood, and the pattern across both tells your doctor more than either number alone.

Source: MedlinePlus (National Library of Medicine), Folic acid - test

(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 folate on a blood test? Folate is vitamin B9 — essential for making red blood cells and repairing DNA. The blood test measures whether you have enough; low folate causes an anemia that looks nearly identical to B12-deficiency anemia, which is why the two are tested together to tell them apart. On billing paperwork it’s CPT code 82746.

Is folate usually ordered with B12 — and does Medicare cover both? Usually, yes — the deficiencies mimic each other, and treating the wrong one can mask the other. Medicare covers each test on its own merits: the same qualifying finding (say, macrocytic anemia) typically justifies both, but each is billed and adjudicated separately.

Do you have to fast for a folate test? Ask — some labs prefer fasting for folate, and it’s often drawn with tests that require it. Follow your order’s instructions. See our guide to fasting before blood work.

Sources and data dates

Medicare payment amount: CMS Clinical Laboratory Fee Schedule, 2026 Q3 file (national rate). Coverage rules: CMS Medicare Coverage Database, LCD L34914 and billing article A56416 (a regional policy used here as the example — your region’s policy may differ in details). 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.