For 2011, Medicare defined the G0431 code as the code to use for the physician practices that are high complex. The reimbursement in most states for the code is $102. A few of the states like TX, for example, reimburse at a lower rate. So, in essence there are two definitive ways to bill for Medicare drug screens. One as a CLIA-waived lab (G0430) and one as a high-complex lab (G0431).

At this time, I only know of one code for UDS in physician practices which is 80101. Typically, commercial payers follow-suit with Medicare. However, in this instance I have not heard or read about any additional codes that would define to the payer that the physician office is running at a high complex level.

My question here is what code, if any, have the commercial payers created to follow Medicare? And, if there is no code at this time, does anyone feel the commercial carriers will create one to follow-suit with Medicare.