Find policies, billing codes, payers, states, and providers
CPT 83036: Glycated Hemoglobin (A1C) Test
CPT code 83036 represents the laboratory measurement of glycated hemoglobin (A1C), a staple test for monitoring average blood glucose control over the prior three months. Nationally, A1C testing is a core component of diabetes screening and chronic disease management, informing treatment plans and quality measurement. The code is widely used across outpatient clinics and clinical laboratories.
Key payers discussed include Aetna, Blue Cross Blue Shield plans, Cigna Health, United Healthcare, and Medicare. Readers will find clinical context on what the test measures and how results are interpreted, plus operational considerations for billing and service location. The publication highlights related laboratory tests commonly ordered alongside A1C and maps typical use cases such as diabetes screening and ongoing diabetes management.
This summary provides a concise reference for clinicians, laboratory managers, and revenue cycle staff who need to understand what CPT code 83036 covers, where the test is typically performed, and which major payers commonly reimburse the service. Data not available in the input is noted where applicable.
Customize your policy alerts
Sign up for cpt 83036 policy alerts
Get alerted when payer policies referencing 83036 are released or updated.
Monitor payer policy activity
Billing Code Overview
CPT code 83036 describes the laboratory measurement of hemoglobin A1C, a blood test that quantifies the percentage of glucose attached to hemoglobin over the preceding ~120 days. The result is reported as a percentage and provides clinicians with an index of average blood glucose control over roughly three months. A commonly cited threshold in clinical settings for controlled diabetes management is an A1C below 7%.
Service Type: Laboratory test (glycated hemoglobin, A1C)
Typical Site of Service: Clinical laboratory or outpatient clinic phlebotomy
National Reimbursement Benchmarks
National commercial reimbursement for CPT 83036 centers around BUCA’s average commercial benchmark of $28.3, with notable variation among large payers. Blue Cross Blue Shield pays higher on average ($40.8 mean) with a median of $38, while Aetna and Cigna sit lower (means $16 and $10.6 respectively). UnitedHealth Group and Cigna show lower medians ($5.80 and $8.80) compared with Blue Cross Blue Shield’s median, indicating a wide gap between dominant payer medians and the BUCA average.
Dispersion (P75 minus P25) highlights where rates are tight or wide: Blue Cross Blue Shield’s interquartile spread is $14.0 ($49.5−$31.6), the widest among payers, signaling broader variability. UnitedHealth Group is the tightest with a spread of $5.3 ($9.7−$4.4), followed by Cigna at $8.5 ($14.0−$5.5) and Aetna at $11.0 ($19.8−$8.0). These spreads contextualize BUCA’s mean as a mid-market reference amid payer-specific variability.