Folate Test Cost and Medicare Coverage (CPT 82746)
Also called: folic acid test · vitamin B9 test · serum folate — all the same test, CPT 82746.
Regional policy — rules vary by state — examples on this page are from one region what's this?
This test is governed by Local Coverage Determinations (LCDs) — rules written by regional Medicare contractors, each binding only in its own territory. Every region keeps its own covered-diagnosis list, so the examples on this page (drawn from one region’s policy) may differ in your state. Want your state’s actual answer? Send us your codes — the free lookup checks the policy that applies to you.
- Does Medicare cover it?
- Only for certain diagnoses — such as unexplained anemia (especially with enlarged red cells), malabsorption conditions, alcohol-related malnutrition, monitoring diagnosed folate deficiency (examples only; details below)
- You pay if covered
- $0 — no deductible, no coinsurance
- Medicare pays the lab
- $14.70
- Information verified
- 2026-09-04
Buy it yourself — what you'd really pay
| Where | Test price | Fee | Total |
|---|---|---|---|
| Jason Health jasonhealth.com | $20 | $18 one fee per order — covers every test on it | $38 |
| Ulta Lab Tests ultalabtests.com Partner link — we earn a commission if you order. No extra cost to you. | $27.95 | $12.95 draw fee — one per order, covers every test on it | $40.90 |
| Quest questhealth.com | $65 | $6 physician service fee | $71 |
| Labcorp ondemand.labcorp.com · sold only as a B12 + folate combo | $89 | — | $89 |
Disclosure: the Ulta Lab Tests link above is a partner link. If you order through it, ClaraCover earns a commission. It costs you nothing extra, and it never changes what we tell you about Medicare coverage.
The short answer
Only when a folate deficiency is genuinely suspected — the same regional vitamin rules that govern B12. Folate testing lives under the same policies as its constant companion, the B12 test: a targeted test backed by findings is covered; a vitamin panel or “check my levels” order is treated as screening and denied. Since the two tests are so often ordered together, one uncovered line can put a signature pad in front of an otherwise covered blood draw — which is exactly why folate sits in our most-denied group.
When Medicare DOES cover it
The covered picture (from one regional policy, LCD L34914):
- Unexplained anemia — especially with enlarged red blood cells on a CBC, the classic folate/B12 signature
- Malabsorption conditions — celiac disease, Crohn’s, and intestinal surgery histories
- Alcohol-related malnutrition — folate is the vitamin alcohol depletes fastest
- Certain medications that interfere with folate (methotrexate and some seizure medicines are the familiar ones)
- Monitoring a diagnosed deficiency — confirming treatment worked, then roughly annually; policies commonly allow up to about 4 tests a year for active deficiency or malabsorption
When Medicare does NOT cover it
- Routine screening and multi-vitamin wellness panels — categorically treated as screening, never covered
- Riding along on a B12 order without its own justification — each test needs the diagnosis to support it
If your test gets flagged, ask your doctor whether a finding on the covered list genuinely describes your situation. (Never ask anyone to change a code just to get coverage — that’s fraud. But doctors often have a legitimate reason for the test that simply wasn’t coded.)
What you pay if it IS covered: $0
Covered lab tests cost Medicare patients nothing — no deductible, no 20% coinsurance. Medicare pays the lab $14.70, and you owe zero.
What you pay if it is NOT covered — read this before you sign
- Ask the lab to print exactly what you would owe. You’re entitled to the number in black and white first. For perspective: when Medicare covers this exact test, it pays the lab $14.70.
- Know the direct prices: $20 at Jason Health (jasonhealth.com — add their flat $18 lab-collection fee per order), $65 at Quest’s consumer site (questhealth.com, plus a $6 physician fee), and $89 at Labcorp OnDemand (sold only bundled with B12). Same certified labs, same blood draw.
Before you sign the pad — 60-second checklist
- Ask: “Can you print what I’ll owe if Medicare doesn’t pay?”
- Ask your doctor: “Does my blood work or history make this test medically necessary — for folate specifically?”
- Compare the printed price to the direct-purchase prices before deciding.
Quick questions people ask
What is folate on a blood test? Folate is vitamin B9 — essential for making red blood cells and repairing DNA. The blood test measures whether you have enough; low folate causes an anemia that looks nearly identical to B12-deficiency anemia, which is why the two are tested together to tell them apart. On billing paperwork it’s CPT code 82746.
Is folate usually ordered with B12 — and does Medicare cover both? Usually, yes — the deficiencies mimic each other, and treating the wrong one can mask the other. Medicare covers each test on its own merits: the same qualifying finding (say, macrocytic anemia) typically justifies both, but each is billed and adjudicated separately.
Do you have to fast for a folate test? Ask — some labs prefer fasting for folate, and it’s often drawn with tests that require it. Follow your order’s instructions.
Sources and data dates
Medicare payment amount: CMS Clinical Laboratory Fee Schedule, 2026 Q3 file (national rate). Coverage rules: CMS Medicare Coverage Database, LCD L34914 and billing article A56416 (a regional policy used here as the example — your region’s policy may differ in details). 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.