HDL Cholesterol Test Cost and Medicare Coverage (CPT 83718)

Also called: HDL-C · good cholesterol test · high-density lipoprotein cholesterol · HDL blood test — all the same test, CPT 83718.

The short answer

Covered on its own when your doctor is diagnosing or monitoring a lipid condition, on the same rhythm as the lipid panel. Medicare’s national lipid policy (NCD 190.23, the same in every state) names HDL as one of the three routine monitoring tests: “To monitor the progress of patients on anti-lipid dietary management and pharmacologic therapy for the treatment of elevated blood lipid disorders, total cholesterol, HDL cholesterol and LDL cholesterol may be used.”

Most people never see HDL billed alone. It arrives inside the lipid panel (CPT 80061), which the same policy covers about once a year for people on treatment. This page is about the test as its own line item, CPT 83718, and about the one thing that gets any lipid test denied: ordering it with no diagnosis behind it. The policy says “routine screening and prophylactic testing for lipid disorder are not covered by Medicare,” and points to a separate law for the screening benefit, which has its own rules and its own page: cholesterol screening.

When Medicare DOES cover it

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

• Monitoring diet or drug treatment for a lipid disorder. HDL is one of the policy’s three named monitoring tests, alongside total cholesterol and LDL.
• Up to six times in the first year of treatment. “Any one component of the panel or a measured LDL may be reasonable and necessary up to six times the first year for monitoring dietary or pharmacologic therapy.” HDL is one of those components.
• More often for marked elevations or a change in treatment. “More frequent total cholesterol, HDL cholesterol, LDL cholesterol and triglyceride testing may be indicated for marked elevations or for changes to anti-lipid therapy due to inadequate initial patient response.”
• Diagnosing a lipid problem. The policy lists “evaluation of primary dyslipidemia,” “any form of atherosclerotic disease,” and “diagnostic evaluation of diseases associated with altered lipid metabolism, such as: nephrotic syndrome, pancreatitis, hepatic disease, and hypo and hyperthyroidism,” plus secondary dyslipidemia from diabetes, absorption disorders, and chronic kidney failure.
• Following up a screening result. The policy covers lipid testing “as follow-up to the initial screen for coronary heart disease (total cholesterol + HDL cholesterol)” when total cholesterol is high, or borderline-high with risk factors, “or an HDL cholesterol, <35 mg/dL.” A low HDL on a screen is itself a reason the policy accepts.
• As part of the yearly panel. For people on long-term treatment, “a lipid panel at a yearly interval will usually be adequate.”

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

• Screening. The policy could not be plainer: “Routine screening and prophylactic testing for lipid disorder are not covered by Medicare. While lipid screening may be medically appropriate, Medicare by statute does not pay for it. Lipid testing in asymptomatic individuals is considered to be screening regardless of the presence of other risk factors.” The exception lives in a different law: “Effective January 1, 2005, the Medicare law expanded coverage to cardiovascular screening services” (42 CFR 410.17). That is the benefit on the cholesterol screening page, once every five years, and it is billed and limited on its own terms.
• Monitoring when nothing is being treated. “If no dietary or pharmacological therapy is advised, monitoring is not necessary.”
• HDL at every interim visit. Between yearly panels, the policy expects “the serum total cholesterol or a measured LDL” to be enough, and after treatment goals are reached it names “the LDL cholesterol or total cholesterol” as the tests that “may be measured three times yearly.” HDL is not on either of those shorter lists, so an HDL billed alone between panels is the line most exposed.
• Vague reasons. “Less specific diagnoses (for example, other chest pain) alone do not support medical necessity of these tests.”

The policy sets no HDL-specific number of tests per year; the six-times-first-year figure applies to any single component, and the yearly figure applies to the panel.

(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 $8.19 for an HDL cholesterol test, and you owe zero.

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

Quest’s own test directory flags HDL cholesterol as “subject to a Medicare Limited Coverage Policy” that “may require a signed ABN when ordering.” (Labcorp’s page carries no such notice.) If HDL is on your order with no lipid diagnosis and no treatment being monitored, 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:

1. 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 test, it pays the lab $8.19.
2. Ask whether this is screening. If you have never been told your lipids are high and are not on treatment, this test is screening under the policy, and the cardiovascular screening benefit is the route that covers it, with its own five-year limit.
3. Know the direct prices: HDL by itself sells for $19.95 at Ulta Lab Tests (partner link in the table; our commission is disclosed there; add their $12.95 draw fee, so $32.90 all in). The cheaper route is a whole lipid panel, which includes HDL: $10 at Jason Health (jasonhealth.com, plus their flat $18 lab-collection fee per order, so $28 all in), $35.70 at Personalabs, $44.25 at Labcorp OnDemand, and $53.10 at Quest’s consumer site plus a $6 physician fee. None of those four sells HDL alone. 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: “Is this monitoring a lipid condition or its treatment, and is that diagnosis on the order?”
3. Compare the printed price to the direct-purchase prices before deciding how to proceed.

What counts as a “normal” HDL level

Start with the range printed on your own report. HDL is the cholesterol number where higher is the good direction, and the consumer sources publish reference figures rather than a treatment target.

Quest’s directory hides its range until a service area is chosen. MedlinePlus adds the caution that applies to every line of a lipid report: “The numbers that are best for you may depend on your age, race, blood pressure, weight, family history, and more.”

There is no clinical target to add for HDL. The synopsis of the 2018 American Heart Association and American College of Cardiology cholesterol guideline that we read sets its thresholds for LDL, not HDL. Cleveland Clinic’s cholesterol page cites that same 2018 guideline, and its HDL figures are reference ranges, not a number treatment aims for.

Two notes from the lab directories on what moves the number: Quest says HDL “increases following regular exercise, moderate alcohol consumption and with oral estrogen therapy” and that “decreased levels are associated with obesity, stress, cigarette smoking and diabetes mellitus.” Labcorp’s directory asks that patients “maintain normal diet and stable weight for one week prior to testing.”

(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 other lipid results and your history.

Quick questions people ask

What is an HDL cholesterol test? A blood test for high-density lipoprotein cholesterol. MedlinePlus says “HDL is often called ‘good’ cholesterol because it helps remove cholesterol from your arteries.” Cleveland Clinic describes HDL particles that “pick up extra cholesterol in your blood and deliver it to your liver,” which breaks it down and removes it. On billing paperwork it is CPT code 83718, and it is also measured as one line of a lipid panel.

Why is HDL called good cholesterol? Because of the direction of the risk. Labcorp’s directory puts it in lab language: “an inverse correlation exists between serum HDL-cholesterol concentrations and the risk of atherosclerotic disease.” Quest says the same: “HDL cholesterol is inversely related to the risk for cardiovascular disease.” MedlinePlus: “A higher HDL level may help reduce your risk of heart attack or stroke.”

Do you have to fast for an HDL test? Not for HDL by itself. Labcorp says fasting is unnecessary for this test, and Quest’s directory says that “if the HDL-cholesterol is ordered as part of a lipid panel, then a fasting sample is not required.” The one exception in Quest’s instructions: if HDL is drawn together with triglycerides but not as a lipid panel, “the patient should be fasting 9-12 hours prior to collection.” Follow the instructions on your order. Our fasting guide explains what fasting means and what you can still drink.

Is an HDL test part of the lipid panel? Yes. MedlinePlus lists HDL as one of the numbers a cholesterol test reports, with total cholesterol, LDL, and triglycerides, and Cleveland Clinic says HDL is measured “through a lipid panel.” When it is billed inside the panel, the panel’s coverage rules and its yearly rhythm apply; this page is about the test billed alone as CPT 83718.

Why would Medicare pay for my LDL but not my HDL? Because between yearly panels the policy names total cholesterol or a measured LDL as the interim tests, and after goals are reached it names LDL or total cholesterol for the up-to-three-times-yearly checks. HDL is covered as a monitoring component, up to six times in the first year of treatment, and inside the yearly panel; it is simply not on the shorter interim lists.

Sources and data dates

Medicare payment amount: CMS Clinical Laboratory Fee Schedule, 2026 Q3 file (national rate for 83718). Coverage rules: CMS Medicare Coverage Database, NCD 190.23 (Lipids Testing), a national policy identical in every state, and the same text in the NCD Manual, Chapter 1, Part 3. Test descriptions, preparation, and ranges: MedlinePlus (Cholesterol Levels: What You Need to Know; Cholesterol Levels lab-tests page), Cleveland Clinic (HDL Cholesterol; Cholesterol Levels), JAMA 2019 synopsis of the 2018 AHA/ACC cholesterol guideline, Quest test 608, Labcorp test 001925. 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.