CBC Blood Test Cost and Medicare Coverage (CPT 85025)

Also called: CBC · CBC with diff · complete blood count · hemogram — all the same test, CPT 85025.

The short answer

Yes — whenever there’s a medical reason on the order, which covers nearly every real-world CBC. The complete blood count is the workhorse of bloodwork, and Medicare’s national policy (NCD 190.15 — the same rules in every state) covers it for an enormous range of symptoms and conditions: anemia, infections, bleeding or bruising, fatigue being evaluated, medication monitoring, and much more. The one thing the policy does not cover is a CBC ordered as pure routine screening with no symptom, condition, or medication behind it.

When Medicare DOES cover it

• Evaluating symptoms — fatigue, weakness, fever, infection signs, unusual bleeding or bruising, and many others
• Diagnosed blood conditions — anemia of any type, clotting and platelet disorders, blood cancers
• Monitoring treatment — many medications (including chemotherapy and drugs that can affect blood counts) require regular CBCs
• Conditions that affect blood counts — chronic kidney disease, inflammatory conditions, and more

One nuance from the national policy: when a CBC comes back normal and nothing changes clinically, repeating it “just to recheck” isn’t considered necessary — repeat testing follows abnormal results or a change in your condition.

When Medicare does NOT cover it

• Routine screening — a CBC ordered with no qualifying reason, symptom, or condition on the order. (An Annual Wellness Visit does not automatically include covered bloodwork.)

What you pay if it IS covered: $0

Covered lab tests cost Medicare patients nothing — no deductible, no 20% coinsurance. Those apply to doctor visits, not lab tests. Medicare pays the lab $7.77 for a CBC with differential, and you owe zero.

What it costs to buy yourself

Here’s the perspective that makes any surprise CBC bill absurd: this test sells direct-to-consumer for $5 at Jason Health (jasonhealth.com — add their flat $18 lab-collection fee per order), about $29 at Quest’s consumer site (questhealth.com, plus a $6 physician fee), and $29 at Labcorp OnDemand. A test that labs happily sell for the price of a sandwich should never cost you three figures — if a payment pad says otherwise, ask them to print what you’d owe before signing anything.

Quick questions people ask

What is a CBC? A complete blood count measures the three kinds of cells in your blood: red blood cells (which carry oxygen — this is where anemia shows up), white blood cells (which fight infection), and platelets (which help blood clot), plus hemoglobin and hematocrit. “With differential” means the white cells are also broken out by type. On billing paperwork it’s CPT code 85025.

Do you have to fast for a CBC? No — a CBC by itself requires no fasting. But it’s often ordered alongside tests that do (like a metabolic panel with glucose), so follow the instructions that came with your order.

Why did my doctor order a CBC? It’s usually the first, broadest look: almost any symptom that could involve infection, anemia, or blood cells starts with a CBC. A normal result rules a lot out cheaply.

Sources and data dates

Medicare payment amount: CMS Clinical Laboratory Fee Schedule, 2026 Q3 file (national rate). Coverage rules: CMS Medicare Coverage Database, NCD 190.15 (Blood Counts) — a national policy, identical in every state. 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.