HIV Screening Test Cost and Medicare Coverage (CPT 87389)
Also called: HIV test · HIV-1/2 antigen-antibody test · 4th generation HIV test — all the same test, CPT 87389 (related codes: 86689, 86701, 86702, 86703, 87390, 87391, 87534, 87535, 87536, 87537, 87538, 87539).
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
- $24.08
- Information verified
- 2026-09-04
Buy it yourself — what you'd really pay
| Where | Test price | Fee | Total |
|---|---|---|---|
| Jason Health jasonhealth.com · 4th-generation antigen/antibody with confirmatory reflexes | $40 | $18 one fee per order — covers every test on it | $58 |
| Quest questhealth.com | $85 | $6 physician service fee | $91 |
| Labcorp ondemand.labcorp.com | $99 | — | $99 |
| Personalabs personalabs.com · price includes the draw; not a partner — we earn nothing from this row | $73.50 | — | $73.50 |
One more place to check: Ulta Lab Tests sells lab tests online and uses Quest labs for the blood draw. Compare their price before you buy. Disclosure: if you order through this link, ClaraCover earns a commission. It costs you nothing extra.
The short answer
Yes — once a year, free, no risk factors needed between ages 15 and 65. Medicare’s HIV screening benefit is national and simple: anyone 15–65 gets an annual screening at $0; outside that age range, an annual screening is covered when there’s increased risk; and pregnant women can be screened up to 3 times per pregnancy. No symptoms, no justification, no questions — it’s preventive care by design.
When Medicare DOES cover it
- Ages 15–65: once every 12 months, automatically eligible
- Under 15 or over 65: once every 12 months with increased risk
- Pregnancy: up to 3 screenings per pregnancy
- Diagnostic testing — after a known exposure or with symptoms — follows ordinary medical-necessity rules at any time, separate from the screening clock.
When Medicare does NOT cover it
- A second screening within the 12-month window (outside pregnancy). As with every screening benefit, the calendar is the rule — you weren’t ineligible, you were early.
What you pay if it IS covered: $0
No deductible, no coinsurance — the screening benefit waives both. Medicare pays the lab $24.08, and you owe zero.
What it costs to buy yourself
Complete privacy, no doctor’s visit, no waiting for eligibility: the modern combination HIV test sells for $40 at Jason Health (jasonhealth.com — add their flat $18 lab-collection fee per order; theirs includes automatic confirmatory testing if positive), $85 at Quest’s consumer site (questhealth.com, plus a $6 physician fee), and $99 at Labcorp OnDemand.
What counts as a “normal” HIV test result
There is no range for this one. An HIV screening test does not produce a number to compare against a range. The result is negative (non-reactive) or positive (reactive).
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
Where can you get tested for HIV? Three easy routes: any lab with your doctor’s order (free under the annual benefit), directly from the consumer lab sites above (private, no order needed), or free and low-cost community testing — health departments and many clinics offer it, and gettested.cdc.gov finds sites near you.
How long do HIV test results take? Lab-based tests like this one typically return results in 1 to 3 business days. Rapid point-of-care tests give a preliminary answer in about 20 minutes, with lab confirmation to follow if reactive.
How soon can HIV be detected by a blood test? Modern lab tests (the “4th generation” antigen/antibody type) can usually detect HIV about 2 to 6 weeks after exposure — earlier than older antibody-only tests. If you’re testing because of a specific recent exposure, tell your doctor the date: it determines whether a repeat test is needed, and whether preventive medication is worth discussing right away.
Do you have to fast for an HIV test? No. Fasting isn’t required. If it’s drawn at the same visit as a test that does need fasting, you fast for the visit. Our fasting guide lists which tests need it.
Sources and data dates
Screening rules: medicare.gov, “HIV screenings.” Medicare payment amount: CMS Clinical Laboratory Fee Schedule, 2026 Q3 file (national rate). 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 87389
There is no national diagnosis list for CPT 87389. 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.