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    v1.0.30
    OpenPayerBilling CodesPresumptive Drug Class Screening ProceduresCPT cpt-80305-presumptive-drug-test-visual-read
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    CPT 80305: Presumptive Drug Test, Visual Read

    Commercial payers pay $40 on average nationally for this procedure.

    CPT code 80305 describes a presumptive drug test performed by a laboratory analyst using direct visual/optical observation only (no instrument assistance) to screen for one or more drug classes on a single date; the service type is point-of-care/clinical laboratory screening, and the typical site of service is clinical laboratory or point-of-care testing location where visually read assays (e.g., immunoassay dipstick or cassette) are completed.

    For related coverage guidance, see recent payer policy updates: Intraosseous Basivertebral Nerve Ablation for Child Health Plus (CHP) and Essential Plan (EP) Members, Acupuncture Services Payment Policy, Drug Testing in Pain Management and Substance Use Disorder.

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    National Reimbursement Benchmarks

    For CPT 80305, BUCA’s average commercial rate sits at $39.7, serving as a useful midpoint for national commercial pricing. Blue Cross Blue Shield has the highest variability with a P75–P25 spread of $34.5 ($72.8 − $37.3), driven by a wide top-end maximum of $295.4 that pulls the mean above most peers. Aetna and Cigna exhibit similar central tendencies near the low teens, while UnitedHealth Group’s median of $7.6 is notably lower than its peers’ medians.

    Assessing dispersion shows UnitedHealth Group and Aetna have the tightest interquartile ranges: UnitedHealth Group’s P75–P25 is $7.0 ($12.6 − $5.6) and Aetna’s is $6.0 ($15.0 − $9.0), indicating more compressed commercial pricing. Blue Cross Blue Shield is the widest at $34.5, with Cigna and BUCA in between (Cigna IQR $8.4; BUCA IQR $21.2), highlighting material differences in commercial rate concentration across payers.

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    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A typical patient is a 28-year-old employee presenting to an occupational health clinic after a workplace incident requiring a post-accident drug screen. The clinic collects a urine specimen under chain-of-custody procedures and sends a portion to the on-site laboratory. The lab analyst performs a presumptive drug screen using an immunoassay test strip read visually (no instrument). The result is documented as a preliminary positive or negative for multiple drug classes (e.g., amphetamines, opioids, cocaine, cannabinoids). If presumptive positive, the specimen is segregated for confirmatory testing (e.g., GC-MS or LC-MS/MS) and results communicated to the ordering clinician. Typical workflow steps: ordering by clinician, specimen collection and labeling, analyst-performed presumptive assay with direct optical reading, documentation of findings, and referral for confirmatory testing or counseling as clinically indicated.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    80305Presumptive drug test(s) by direct optical observation onlyPrimary procedure: visually read presumptive screen for multiple drug classes performed by lab analyst.
    Data not available in the input.

    Related Modifiers

    8 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    77Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    1835C0205X
    103TP0814X
    1744R1102X
    176B00000X
    311500000X
    2865M2000X
    3747P1801X
    163WR0400X

    Related ICD-10-CM Codes

    29 rows

    ICD-10-CM CodeDescription
    F10.10Alcohol abuse, uncomplicated
    F10.20Alcohol dependence, uncomplicated
    F10.21Alcohol dependence, in remission
    F11.10Opioid abuse, uncomplicated
    F11.20Opioid dependence, uncomplicated
    F11.21Opioid dependence, in remission
    F12.10Cannabis abuse, uncomplicated
    F12.20Cannabis dependence, uncomplicated
    F14.10Cocaine abuse, uncomplicated
    F14.20Cocaine dependence, uncomplicated

    Showing 1–10 of 29

    Related Payer Policy Updates

    Specialty: Pain Management1 / 2

    10 rows

    PolicyPayerEffective Date
    Intraosseous Basivertebral Nerve Ablation for Child Health Plus (CHP) and Essential Plan (EP) Membersuniverahealthcare2027-01-01
    Acupuncture Services Payment Policyfallon_community_health_plan_inc2026-12-01
    Drug Testing in Pain Management and Substance Use Disorderbcbsvermont2026-11-01
    Lysis of Epidural Adhesionsexcellus_health_plan_inc2026-10-15
    Intradiscal Proceduresexcellus_health_plan_inc2026-10-15
    Radiofrequency Facet and Sacroiliac Joint Ablation/ Denervationuniverahealthcare2026-10-15
    Facet Joint Injections/ Medial Branch Blocksuniverahealthcare2026-10-15
    Lysis of Epidural Adhesions (Epidural Adhesiolysis)univerahealthcare2026-10-15
    Epidural Steroid Injections / Selective Nerve Root Block (SNRB)univerahealthcare2026-10-15
    Prolotherapyuniverahealthcare2026-10-15

    Related Codes

    CPT-80306-PRESUMPTIVE-DRUG-TESTING-IMMUNOASSAY

    CPT 80306: Presumptive Drug Screen, Instrument-Read

    CPT-80307-PRESUMPTIVE-INSTRUMENTED-DRUG-SCREEN

    CPT 80307: Presumptive Drug Test by Instrumented Analyzer

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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