Hemoglobin A1c Test Cost and Medicare Coverage (CPT 83036)
Also called: A1c · HbA1c · glycated hemoglobin · glycosylated hemoglobin — all the same test, CPT 83036.
National policy — the same Medicare rules apply in every state what's this?
This test is governed by a National Coverage Determination (NCD) — a rule issued by CMS, the federal agency that runs Medicare. It spells out which diagnoses justify the test and any frequency limits, it applies identically in all 50 states, and no regional contractor can override it. What you read on this page is the rule everywhere.
- Does Medicare cover it?
- Yes — with frequency limits
- You pay if covered
- $0 — no deductible, no coinsurance
- Medicare pays the lab
- $9.71
- Information verified
- 2026-09-04
Buy it yourself — what you'd really pay
| Where | Test price | Fee | Total |
|---|---|---|---|
| Jason Health jasonhealth.com | $15 | $18 one fee per order — covers every test on it | $33 |
| Ulta Lab Tests ultalabtests.com Partner link — we earn a commission if you order. No extra cost to you. | $22.95 | $12.95 draw fee — one per order, covers every test on it | $35.90 |
| Quest questhealth.com | $39 | $6 physician service fee | $45 |
| Labcorp ondemand.labcorp.com | $39 | — | $39 |
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
Yes — on a schedule. The A1c is covered two different ways, and knowing which one applies to you is the whole game. If you have diabetes, Medicare’s national policy covers A1c testing to monitor your control — routinely about once every 3 months, more often only when your treatment genuinely calls for it. If you don’t have diabetes, a rule change that took effect January 1, 2024 made the A1c a covered screening test too: up to twice every 12 months, free, for people with risk factors — something many doctors’ offices still haven’t caught up with.
When Medicare DOES cover it
- Monitoring diabetes — the classic use, under Medicare’s national policy (NCD 190.21). About every 3 months for stable, controlled diabetes; testing more than 4 times a year is allowed when control is genuinely off and the chart documents why. (Pregnant women with diabetes can be tested as often as monthly.)
- Screening for diabetes — since January 1, 2024, Medicare’s diabetes-screening benefit accepts the A1c (it used to accept only fasting glucose tests). Up to 2 screenings every 12 months for people at risk — and the risk-factor list is broad: high blood pressure, high cholesterol, obesity, family history, history of high blood sugar or gestational diabetes.
When Medicare does NOT cover it
- Monitoring more often than the schedule supports — a controlled diabetic tested monthly “just to keep an eye on it” will generate denials; the every-3-months rhythm is the covered norm.
- A third screening within 12 months for someone without diabetes.
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), and the screening version explicitly waives both. Medicare pays the lab $9.71 for an A1c, and you owe zero.
What it costs to buy yourself
Want one between covered tests? The A1c sells direct-to-consumer for $15 at Jason Health (jasonhealth.com — add their flat $18 lab-collection fee per order, one fee for the whole order), about $39 at Quest’s consumer site (questhealth.com, plus a $6 physician fee), and $39 at Labcorp OnDemand. Compare that to any payment-pad quote before you sign.
Quick questions people ask
How much does an A1c test cost? If Medicare covers it — monitoring diabetes, or one of your two yearly screenings — $0. Buying it yourself: $15–$39 plus small fees at the labs above. Medicare itself pays labs $9.71, so treat any large quote with suspicion and ask for it in writing.
What does “Hgb A1c” mean on my blood work? Hemoglobin A1c measures the percentage of your red blood cells’ hemoglobin that has sugar attached — a 2-to-3-month average of your blood sugar, unlike a glucose test’s single-moment snapshot. That’s why it’s the standard for both diagnosing risk and tracking diabetes control. On billing paperwork it’s CPT code 83036.
How often will Medicare pay for an A1c? With diabetes: about every 3 months routinely, more with documented need. Without diabetes: up to 2 screening tests every 12 months (since January 2024). If you’re told you’re due, a quick “when was my last one?” check avoids a too-soon denial.
Do you have to fast for an A1c? No — the A1c doesn’t require fasting, which is exactly why the 2024 screening change matters (the old screening tests required fasting; this one is a walk-in blood draw).
Sources and data dates
Medicare payment amount: CMS Clinical Laboratory Fee Schedule, 2026 Q3 file (national rate). Monitoring rules: CMS Medicare Coverage Database, NCD 190.21 (national). Screening rules: CMS MLN Matters MM13487 implementing the CY2024 Physician Fee Schedule final rule — A1c accepted for diabetes screening, up to 2 per 12 months, deductible and coinsurance waived. 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.