HIV Screening Test Cost and Medicare Coverage (CPT 87389)
Also called: HIV test · HIV-1/2 antigen-antibody test · 4th generation HIV test — all the same test, CPT 87389.
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
- $24.08
- Information verified
- 2026-09-04
Buy it yourself — what you'd really pay
| Where | Test price | Fee | Total |
|---|---|---|---|
| Jason Health jasonhealth.com · 4th-generation antigen/antibody with confirmatory reflexes | $40 | $18 one fee per order — covers every test on it | $58 |
| Quest questhealth.com | $85 | $6 physician service fee | $91 |
| Labcorp ondemand.labcorp.com | $99 | — | $99 |
One more place to check: Ulta Lab Tests sells lab tests online and uses Quest labs for the blood draw. Compare their price before you buy. Disclosure: if you order through this link, ClaraCover earns a commission. It costs you nothing extra.
The short answer
Yes — once a year, free, no risk factors needed between ages 15 and 65. Medicare’s HIV screening benefit is national and simple: anyone 15–65 gets an annual screening at $0; outside that age range, an annual screening is covered when there’s increased risk; and pregnant women can be screened up to 3 times per pregnancy. No symptoms, no justification, no questions — it’s preventive care by design.
When Medicare DOES cover it
- Ages 15–65: once every 12 months, automatically eligible
- Under 15 or over 65: once every 12 months with increased risk
- Pregnancy: up to 3 screenings per pregnancy
- Diagnostic testing — after a known exposure or with symptoms — follows ordinary medical-necessity rules at any time, separate from the screening clock.
When Medicare does NOT cover it
- A second screening within the 12-month window (outside pregnancy). As with every screening benefit, the calendar is the rule — you weren’t ineligible, you were early.
What you pay if it IS covered: $0
No deductible, no coinsurance — the screening benefit waives both. Medicare pays the lab $24.08, and you owe zero.
What it costs to buy yourself
Complete privacy, no doctor’s visit, no waiting for eligibility: the modern combination HIV test sells for $40 at Jason Health (jasonhealth.com — add their flat $18 lab-collection fee per order; theirs includes automatic confirmatory testing if positive), $85 at Quest’s consumer site (questhealth.com, plus a $6 physician fee), and $99 at Labcorp OnDemand.
Quick questions people ask
Where can you get tested for HIV? Three easy routes: any lab with your doctor’s order (free under the annual benefit), directly from the consumer lab sites above (private, no order needed), or free and low-cost community testing — health departments and many clinics offer it, and gettested.cdc.gov finds sites near you.
How long do HIV test results take? Lab-based tests like this one typically return results in 1 to 3 business days. Rapid point-of-care tests give a preliminary answer in about 20 minutes, with lab confirmation to follow if reactive.
How soon can HIV be detected by a blood test? Modern lab tests (the “4th generation” antigen/antibody type) can usually detect HIV about 2 to 6 weeks after exposure — earlier than older antibody-only tests. If you’re testing because of a specific recent exposure, tell your doctor the date: it determines whether a repeat test is needed, and whether preventive medication is worth discussing right away.
Sources and data dates
Screening rules: medicare.gov, “HIV screenings.” Medicare payment amount: CMS Clinical Laboratory Fee Schedule, 2026 Q3 file (national rate). 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.