Summary & Overview
CPT 87389: HIV-1 Antigen and HIV-1/HIV-2 Antibody Detection by Immunoassay
CPT code 87389 represents a laboratory procedure for the detection of HIV-1 antigens and HIV-1 and HIV-2 antibodies using advanced immunoassay techniques. This code is central to HIV screening and diagnosis, supporting public health efforts to identify and manage HIV infections. The procedure is commonly performed in office-based settings and is recognized by major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.
This publication provides a comprehensive overview of 87389, including payer coverage, clinical context, and related billing codes. Readers will gain insight into current policy updates, reimbursement benchmarks, and the role of this code in infectious disease screening. The analysis also highlights common modifiers and associated taxonomies relevant to laboratory and physician billing. By understanding the scope and application of 87389, stakeholders can better navigate the evolving landscape of HIV testing and laboratory services.
CPT Code Overview
CPT code 87389 is used for the detection of infectious agent antigens by immunoassay techniques, specifically targeting HIV-1 antigens along with HIV-1 and HIV-2 antibodies, resulting in a single qualitative or semiquantitative outcome. This procedure utilizes methods such as enzyme immunoassay (EIA), enzyme-linked immunosorbent assay (ELISA), fluorescence immunoassay (FIA), or immunochemiluminometric assay (IMCA) in a multiple-step process. The service falls under Pathology and Laboratory Procedures – Microbiology Procedures – Infectious Agent Antigen Detection and is typically performed in an office setting (POS 11).
Clinical & Coding Specifications
Clinical Context
A patient presents to a primary care office for routine screening for human immunodeficiency virus (HIV). The provider orders a laboratory test to detect HIV-1 antigen(s) and HIV-1 and HIV-2 antibodies using a multiple-step immunoassay method. The specimen is collected in the office and sent to a clinical medical laboratory for analysis. The result provides a single qualitative or semiquantitative outcome for HIV-1 antigen(s) and HIV-1/HIV-2 antibodies. This workflow is typical for preventive screening or diagnostic evaluation of HIV status in adults and adolescents.
Coding Specifications
- Modifier
92: Used when the test is performed using a disposable or transportable, single-use kit (point-of-service testing), such as in-office rapid testing platforms.
| Modifier Code | Description |
|---|---|
92 | Alternative laboratory platform testing when the test is performed using a disposable or transportable, single-use kit (point-of-service testing) |
- Associated Provider Taxonomies:
| Taxonomy Code | Specialty |
|---|---|
291U00000X | Clinical Medical Laboratory |
207Q00000X | Family Medicine Physician |
207R00000X | Internal Medicine Physician |
These taxonomies represent the clinical medical laboratory performing the test and the physicians who may order the screening.
Related Diagnoses
Z11.4: Encounter for screening for human immunodeficiency virus (HIV)- This code is used when a patient is being screened for HIV, which is clinically relevant to the procedure described by CPT code
87389as it represents the reason for ordering the HIV antigen/antibody test.
- This code is used when a patient is being screened for HIV, which is clinically relevant to the procedure described by CPT code
Related CPT Codes
-
86703: Antibody; HIV-1 and HIV-2, single result (HIV-1 and HIV-2 combined)- Used for detecting HIV-1 and HIV-2 antibodies, often as an alternative or follow-up to antigen/antibody combination tests.
-
86701: Antibody; HIV-1- Used for detecting HIV-1 antibodies specifically, may be ordered separately in certain clinical scenarios.
-
86702: Antibody; HIV-2- Used for detecting HIV-2 antibodies specifically, may be ordered separately if clinically indicated.
-
87390: Infectious agent antigen detection by immunoassay technique... HIV-1 antigen(s), with HIV-1 and HIV-2 antibodies, single result- Similar to
87389, may be used as an alternative depending on laboratory methodology.
- Similar to
-
87391: Infectious agent antigen detection by immunoassay technique... HIV-2- Used for detecting HIV-2 antigen(s) specifically, may be ordered in addition to or instead of combination tests.
These codes are related to HIV screening and diagnosis. Some are used together in confirmatory workflows, while others serve as alternatives based on clinical and laboratory protocols.
National Reimbursement Benchmarks
National mean rates for CPT code 87389 show that commercial payers, represented by BUCA, average $23.32, while Medicare rates are not available in the input. Among individual commercial payers, Cigna has the highest mean rate at $28.89, and UnitedHealth Group has the lowest at $20.04.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies across payers. Blue Cross Blue Shield has the tightest range at $11.00, while Cigna exhibits the widest spread at $19.89, indicating greater variability in Cigna's contracted rates. Aetna, UnitedHealth Group, and BUCA fall in between, with ranges of $12.00, $11.33, and $11.89, respectively.
The table and chart below present the full breakdown of national benchmarks for CPT code 87389 across major commercial payers.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.