Fee Schedule

NOTE:

For Clients/Visits after July 1, 2023, please visit our new Billing page.

For Clients/Visits prior to July 1, 2023, you can refer to this Fee Schedule, contact support@samedayhealth.com, or call (310) 697-8126.

CPT Code Description Charge Section 4201 Compliance
86328 Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single-step method (eg, reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) $75 Zero out-of-pocket patient responsibility is expected for medically appropriate testing ordered by an authorized provider when billed to a health plan or the government.
87426 Infectious agent antigen detection by immuno assay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARSCoV-2 [COVID-19]) $95 Zero out-of-pocket patient responsibility is expected for medically appropriate testing ordered by an authorized provider when billed to a health plan or the government.
87428 Infectious agent antigen detection by immunofluorescent technique; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID19]) and influenza virus types A and B $165 Zero out-of-pocket patient responsibility is expected for medically appropriate testing ordered by an authorized provider when billed to a health plan or the government.
87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) $250 Zero out-of-pocket patient responsibility is expected for medically appropriate testing ordered by an authorized provider when billed to a health plan or the government.
87811 Infectious agent antigen detection by immunoassay with direct optical (ie, visual) observation; severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) $95 Zero out-of-pocket patient responsibility is expected for medically appropriate testing ordered by an authorized provider when billed to a health plan or the government.
99211 Non-Clinician Office Visit for the purpose of Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(Coronavirus disease [COVID-19]), any specimen source $75 Zero out-of-pocket patient responsibility is expected for medically appropriate testing ordered by an authorized provider when billed to a health plan or the government.
99202/99212 Level 2 Office Visit. Minimal Risk Patient. Straight forward Medical Decision Making. Minimal complexity. $250 Zero out-of-pocket patient responsibility is expected for medically appropriate testing ordered by an authorized provider when billed to a health plan or the government.
99203/99213 Level 3 Office Visit. Low Risk Patient. Low level of Medical Decision Making. Low Complexity. $450 Zero out-of-pocket patient responsibility is expected for medically appropriate testing ordered by an authorized provider when billed to a health plan or the government.