Vitamin D; 25 hydroxy, includes fraction(s), if performed

Measurement of 25‑hydroxyvitamin D is covered when clinically indicated for a range of conditions associated with vitamin D deficiency or altered metabolism (e.g., CKD stage III+, bone disease, malabsorption, certain granulomatous or chronic diseases, post‑bariatric surgery, long‑term medication use). Reimbursement is limited to one test per 24 hours and generally no more than three tests per year, with monitoring after replacement typically at 3–4 months and once‑yearly testing after normalization; 1,25‑dihydroxyvitamin D should not be routinely ordered in addition to 25‑hydroxy for deficiency assessment. Documentation in the medical record must support the listed indication and adherence to applicable CMS guidance.

"Measure 25‑hydroxyvitamin D for patients with chronic kidney disease stage III or greater."

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