Insurance Coverage

The Center for SIBO Testing is contracted with the following health insurance carriers: Premera, Regence, Blue Cross Blue Shield, Lifewise, First Choice Health, Providence Health Plan, Kaiser Permanente (through First Choice), Bridgespan, Asuris, Cigna, Molina (Marketplace and Medicaid only), and Coordinated Care (excluding Apple Health Medicaid).  While all of these carriers provide coverage for SIBO testing, coverage and benefits are specific to the patient’s individual health plan.   Please note that The Center for SIBO Testing is not contracted with Medicare, Medicaid, Tricare, Aetna, or United Healthcare. Please note that Kaiser Permanente covers this test only if ordered by a gastroenterologist.

What to Ask Your Insurance Carrier

Before requesting a SIBO test, please call your insurance company and ask whether hydrogen and methane breath testing is covered under your insurance plan. By providing the following specific information, your insurance carrier should be able to tell you definitely what your coverage for this test will be:

  • Procedure code (also known as CPT code): 91065; hydrogen and methane breath testing
  • Billing provider: Dr. Rian Shah
  • Billing provider NPI: 1285948695
  • Rendering facility: Cascade Integrative Medicine, which is the parent company of the Center for SIBO Testing
  • Rendering facility tax ID: 46-5114957

Also, be sure to ask whether coverage for hydrogen and methane breath testing requires preauthorization.  If so, your provider should submit a preauthorization request to your insurance carrier BEFORE ordering this test for you.

Fee for SIBO Testing

Unless your provider indicates that you do not want your laboratory charges submitted to your insurance carrier, and as long as we are contracted with your insurance carrier, we will submit a claim to your insurance carrier for the laboratory fees. If your health insurance policy is with one of our in-network insurance carriers, most, if not all, of the laboratory fees will be covered.  If the laboratory fees are not covered, or are partially covered, by your insurance policy, or if you elect not to have your claim submitted to your insurance carrier, you will be responsible for no more than $225.00 for all laboratory charges.  This fee is all-inclusive and covers the cost of the test kit, all laboratory charges, and shipping to and from the patient’s home.