TSH Test Cost and Medicare Coverage (CPT 84443)

Also called: thyroid test · thyrotropin · thyroid function test — all the same test, CPT 84443.

The short answer

Yes — with one of the broadest covered lists in the lab rulebook, and one rhythm rule. Medicare’s national policy (NCD 190.22, the same in every state) covers TSH testing for diagnosing and managing thyroid problems — and its list of qualifying reasons is remarkably wide, from obvious thyroid disease to fatigue workups, unexplained depression, heart-rhythm problems, high cholesterol, and more. The rule that generates surprise bills isn’t whether but how often: for patients whose thyroid treatment is stable, the covered rhythm is up to twice a year.

When Medicare DOES cover it

• Diagnosing thyroid problems — confirming or ruling out an overactive or underactive thyroid
• Monitoring treatment — thyroid hormone replacement (like levothyroxine) and hyperthyroidism therapy both need regular TSH checks; goiter, nodules, and thyroid cancer follow-up are covered too
• Working up symptoms and related conditions — the national list is long: fatigue and malaise, unexplained depression, certain anemias, heart arrhythmias, high cholesterol, menstrual disorders, skin and muscle complaints, and a wide array of other signs the thyroid can cause

When Medicare does NOT cover it

• More than twice a year for a stable patient. If your dose hasn’t changed and you feel fine, quarterly TSH checks are beyond the covered rhythm. The exception is built into the rule: a changed dose or new symptoms resets medical necessity — and those belong documented on the order.
• Pure routine screening with no symptom, condition, or medication in the picture.

What you pay if it IS covered: $0

Covered lab tests cost Medicare patients nothing — no deductible, no 20% coinsurance. Medicare pays the lab $16.80 for a TSH, and you owe zero.

What it costs to buy yourself

Want a check between covered tests — or a baseline without a doctor’s visit? The TSH sells direct-to-consumer for $10 at Jason Health (jasonhealth.com — add their flat $18 lab-collection fee per order), and $49 at both Quest’s consumer site (questhealth.com, plus a $6 physician fee) and Labcorp OnDemand. Same certified labs, same blood draw.

Quick questions people ask

How do you get your thyroid checked? The TSH is the first-line test — it’s the most sensitive single indicator of thyroid trouble, which is why doctors start there before adding tests like free T4. Through your doctor: describe your symptoms (the covered list is broad enough that a genuine complaint usually qualifies). On your own: buy the test directly from the labs above for as little as $28 all-in — no coverage rules, no surprise bills.

Do you have to fast for a TSH blood test? No — fasting isn’t required for a TSH. One timing note worth knowing: if you take thyroid medication, many doctors prefer the blood draw before your morning dose, so ask how your doctor wants it done.

How often will Medicare pay for a TSH? Up to twice a year when you’re stable; more often when your dose changed or new symptoms appeared (and your chart says so). If you’re being tested more frequently and you’re not sure why, that’s a fair question for your doctor’s office.

What if my TSH comes back abnormal? The usual next step is more specific testing — free T4, sometimes free T3 or antibodies — each a separate test with its own code and price. An abnormal TSH plus follow-up testing is squarely inside the covered picture.

Sources and data dates

Medicare payment amount: CMS Clinical Laboratory Fee Schedule, 2026 Q3 file (national rate). Coverage rules: CMS Medicare Coverage Database, NCD 190.22 (Thyroid Testing) — 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.