Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.30
    OpenPayerBilling CodesPresumptive Drug Class Screening ProceduresCPT cpt-80306-presumptive-drug-testing-immunoassay
    Ask Trek AI about this page

    CPT 80306: Presumptive Drug Screen, Instrument-Read

    Commercial payers pay $30 on average nationally for this procedure.

    CPT code 80306 describes a presumptive drug screening performed by a laboratory analyst using instrument-assisted direct optical observation (commonly immunoassay) to screen one or more drug classes on a single date; service type: presumptive toxicology/drug screen (instrument-read immunoassay); typical site of service: clinical laboratory or outpatient laboratory collection site where instrument-based immunoassay testing is performed.

    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.

    Customize your policy alerts

    Sign up for cpt 80306 policy alerts

    Get alerted when payer policies referencing 80306 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    National Reimbursement Benchmarks

    Across national commercial payers, BUCA (average commercial) centers near $30.4 for CPT 80306, offering a useful midpoint for comparison. Blue Cross Blue Shield displays the highest mean at $42.5 and a wide interquartile spread ($44.10 p75 minus $37.80 p25 = $6.30), while Cigna’s mean of $16.4 and Aetna’s mean of $12.6 sit well below BUCA. UnitedHealth Group and Aetna have lower medians ($10.3 and $13.0 respectively) compared with Blue Cross Blue Shield and Cigna.

    Dispersion varies meaningfully by payer: Blue Cross Blue Shield’s IQR equals $6.30, the widest among payers, indicating greater regional or contractual variability. UnitedHealth Group shows a tighter IQR of $9.00 (p75 $17.10 minus p25 $7.20 = $9.90) and Cigna’s IQR is $12.40 (p75 $21.40 minus p25 $9.00 = $12.40), while Aetna’s IQR is $6.00 (p75 $16.00 minus p25 $10.00 = $6.00), making Aetna one of the tighter distributions around its median.

    Table of contents

    Progress1 / 9

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • Facility ComparisonBeds, revenue & payer mix
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools
    National Payer Mean Reimbursement Rates

    State Reimbursement Rates

    State: Alaska1 / 51

    Rate by payer

    Clinical & Coding Specifications

    Clinical Context

    A 32-year-old patient presents to an outpatient addiction medicine clinic for routine monitoring during a medication-assisted treatment program. A urine sample is collected and sent to the clinic laboratory. The lab analyst performs a presumptive instrument-read urine drug screen using an immunoassay panel that simultaneously screens multiple drug classes (e.g., opioids, benzodiazepines, amphetamines, cocaine metabolites, THC). Results are reviewed by the clinic and documented in the medical record the same day; any presumptive positives may prompt confirmatory testing by a reference laboratory. Typical workflow: sample collection at point of care or sent to lab → accessioning and labeling → instrument-assisted immunoassay presumptive screen (80306) → result entry and clinician review → reflex confirmatory testing if required → clinical follow-up and documentation.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    80307Drug confirmation, any number of drug classes; chromatographic method (eg, GC, LC), includes immunoassay when performed, and confirmation by mass spectrometry or other definitive methodsUsed when a presumptive positive on 80306 is confirmed by definitive laboratory methods

    Related Modifiers

    7 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…
    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…
    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…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    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…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    207Q00000X
    207L00000X
    208D00000X
    3336C0002X
    385HR2050X
    261QR0400X
    261QM0801X
    152WP0200X

    Related ICD-10-CM Codes

    24 rows

    ICD-10-CM CodeDescription
    F10.10Alcohol abuse, uncomplicated
    F10.20Alcohol dependence, uncomplicated
    F11.10Opioid abuse, uncomplicated
    F11.20Opioid dependence, uncomplicated
    F12.10Cannabis abuse, uncomplicated
    F12.20Cannabis dependence, uncomplicated
    F13.20Sedative, hypnotic or anxiolytic dependence, uncomplicated
    F14.20Cocaine dependence, uncomplicated
    F17.200Nicotine dependence, unspecified, uncomplicated
    F17.210Nicotine dependence, cigarettes, uncomplicated

    Showing 1–10 of 24

    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-80305-PRESUMPTIVE-DRUG-TEST-VISUAL-READ

    CPT 80305: Presumptive Drug Test, Visual 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.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

    81002
    Urinalysis, non-automated, without microscopy
    Often performed alongside 80306 to evaluate urine appearance, concentration, and basic chemistry
    81003Urinalysis, non-automated, with microscopyPerformed when microscopic evaluation is clinically indicated after abnormal screening results
    36415Collection of venous blood by venipunctureMay be used if blood testing is required for confirmatory or additional toxicology assays
    G0480Drug testing, definitive, any number of drug classes, separate procedure (Medicare)Alternative definitive testing code used in some payer workflows when confirmation is performed