Folate (Folic Acid) (CPT 82746)
Medicare Rate vs. Lab Charges
Medicare pays $14.49 for this test. Labs commonly charge $45.00–$170.00. That's a 211%–1073% markup above what Medicare pays.
What This Test Is
Folate (folic acid) is a B vitamin essential for red blood cell production and DNA synthesis. Low folate causes anemia and neurological problems. It's ordered to evaluate anemia, neuropathy, or in patients with poor diet or GI absorption issues.
Medicare Rate vs. Lab Charges
| Medicare Allowable Rate | $14.49 |
| Typical Lab Charge Range | $45.00–$170.00 |
| Average Markup Above Medicare | 211%–1073% |
Does Medicare Cover This Test?
Yes, Medicare Part B covers folate testing when ordered to evaluate anemia, neurological symptoms, or confirmed folate deficiency.
Common Reasons for Denial
- Routine screening in asymptomatic patients without risk factors
- Supplement monitoring without documented deficiency
- Tested too frequently without symptom change
- No diagnosis code indicating reason for test
- Duplicate test within short timeframe
What To Do If You're Overcharged
If you received a lab bill that seems unusually high compared to Medicare rates:
- Check your Explanation of Benefits (EOB) from Medicare or your insurance to see what should have been paid.
- Request an itemized bill from the lab showing all charges.
- Compare to GougeStop rates for your area to see if the charge is reasonable.
- Contact the lab's billing department to dispute erroneous charges or negotiate a lower rate.
- File an appeal with Medicare if a claim was incorrectly denied.
Frequently Asked Questions
A: People with poor diet (inadequate vegetables/grains), alcoholism, GI diseases (Crohn's, celiac), and those on certain medications (methotrexate, sulfasalazine).
A: Only if deficiency is documented or you're planning pregnancy (folic acid prevents neural tube defects). Otherwise, a normal diet usually provides enough.
A: When medically necessary (anemia workup, documented deficiency, high-risk patient). Routine screening is less likely to be covered.