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TITLE 25HEALTH SERVICES
PART 1DEPARTMENT OF STATE HEALTH SERVICES
CHAPTER 73LABORATORIES
RULE §73.54Fee Schedule for Clinical Testing and Newborn Screening

(a) Tests performed on clinical specimens, Austin Laboratory.

  (1) Biochemistry and genetics.

    (A) Newborn screening.

      (i) Newborn screening panel--$33.60. (Fees are based on the newborn screening specimen collection kit which is a department approved, bar-coded, FDA approved medical specimen collection device that includes a filter paper collection device, parent information sheet, specimen storage and use information, parent disclosure request form, demographic information sheet, and specimen collection directions with protective wrap-around cover for the specimen that should be used to submit a newborn's blood specimen for the first or second screen, repeat or follow-up testing and which includes the cost of screening.)

      (ii) Amino Acid Dietary Monitoring--$16.61.

      (iii) Phenylalanine/tyrosine--$16.61.

    (B) Clinical chemistry.

      (i) Antibody screen--$20.51.

      (ii) Blood typing ABO--$20.51.

      (iii) Cholesterol--$5.18.

      (iv) Glucose:

        (I) glucose fasting--$4.30;

        (II) glucose post prandial (1 hour)--$8.60;

        (III) glucose post prandial (2 hour)--$12.90;

        (IV) glucose random--$4.30;

        (V) glucose tolerance test 1 hour--$8.60;

        (VI) glucose tolerance test 2 hour--$12.90; and

        (VII) glucose tolerance test 3 hour--$17.20.

      (v) Hematocrit--$6.62.

      (vi) Hemoglobin--$1.53.

      (vii) Hemoglobin electrophoresis--$3.98.

      (viii) High-density lipoprotein (HDL)--$6.02.

      (ix) Lead--$3.47.

      (x) Lipid panel (consists of cholesterol, triglycerides, high density lipoprotein (HDL), and low density lipoprotein (LDL))--$15.04.

    (C) DNA Analysis.

      (i) Cystic fibrosis mutation panel--$147.22.

      (ii) Hemoglobin (Hb) DNA:

        (I) HbS, HbC, HbE, HbD or HbO-Arab--$186.84;

        (II) common beta-thalassemia mutation--$213.21; and

        (III) beta-globin gene sequencing--$783.42.

      (iii) Galactosemia common mutation panel--$383.21.

      (iv) Medium chain acyl-CoA dehydrogenase deficiency (MCAD), common mutation panel--$280.79.

      (v) Very long chain acyl-CoA dehydrogenase deficiency (VLCAD), full gene sequencing--$1596.93.

  (2) Microbiology.

    (A) Bacteriology. Charges for bacteriology testing will be based upon the actual testing performed as determined by suspect organisms, specimen type and clinical history provided.

      (i) Aerobic isolation from clinical specimen--$303.92.

      (ii) Anaerobic identification, pure culture--$146.70.

      (iii) Anaerobic isolation from clinical specimen--$118.39.

      (iv) Bacteriology pulsed field gel electrophoresis (PFGE)--$112.67.

      (v) Culture, stool--$158.07.

      (vi) Definitive identification:

        (I) bacillus--$165.27;

        (II) group B streptococcus (Beta strep)--$113.70;

        (III) Bordetella --$147.77;

        (IV) Bordetella pertussis, Parapertussis, and Bordetella holmesii detection by real-time polymerase chain reaction (PCR)--$213.79;

        (V) Campylobacter --$166.88;

        (VI) Gonorrhea/Chlamydia (GC/CT):

          (-a-) GC/CT, amplified RNA probe--$20.28;

          (-b-) GC culture confirmation by amplified or direct probe--$37.66; and

          (-c-) GC screen--$44.54.

        (VII) gram negative rod--$261.00;

        (VIII) gram positive rod--$226.12;

        (IX) Haemophilus --$107.64;

        (X) Legionella --$265.57;

        (XI) Neisseria --$141.84;

        (XII) pertussis--$287.98;

        (XIII) Staphylococcus --$188.88;

        (XIV) Streptococcus --$258.91; and

        (XV) Vibrio--$228.15.

      (vii) Diphtheria screen--$62.65.

      (viii) Enteric bacteria:

        (I) culture confirmation--$158.53;

        (II) Shigella serotyping--$120.38; and

        (III) Salmonella serotyping--$86.63.

      (ix) Enterohaemorrhagic Escherichia Coli (EHEC), shiga-like toxin assay--$38.60.

      (x) Escherichia coli (E. coli), serotyping--$25.71.

      (xi) Group B streptococcus screen--$48.32.

      (xii) Haemophilus:

        (I) Influenzae serotyping--$79.64; and

        (II) isolation from clinical specimen--$100.18.

      (xiii) Kirby Bauer--$9.92.

      (xiv) Neisseria meningitides, serotyping--$167.48.

      (xv) Shiga toxin producing E. coli, PCR--$117.90.

      (xvi) Toxic shock syndrome toxin I assay (TSST 1)--$125.25.

      (xvii) Vibrio cholera, serotyping--$32.73.

    (B) Emergency preparedness.

      (i) Biological threat agent analysis.

        (I) Definitive identification:

          (-a-) Bacillus anthracis --$420.73;

          (-b-) Brucella species--$669.70;

          (-c-) Burkholderia pseudomallei --$519.72;

          (-d-) Francisella tularensis --$534.55; and

          (-e-) Yersinia pestis --$485.23.

        (II) Culture:

          (-a-) all aerobes--$153.51; and

          (-b-) Botulinum (human)--$231.82.

        (III) Toxin Assay, Botulinum--$235.57.

        (IV) PCR:

          (-a-) Bacillus anthraci --$69.16;

          (-b-) Brucella abortus --$164.20;

          (-c-) Burkholderia pseudomallei --$50.88;

          (-d-) Coxiella burnetii --$229.31;

          (-e-) Francisella tularensis --$165.95;

          (-f-) Orthopox--$124.27;

          (-g-) Vaccinia--$165.78;

          (-h-) Variola--$165.78;

          (-i-) Varicella zoster virus--$221.72;

          (-j-) Yersinia pestis --$51.36; and

          (-k-) Unknown biological threat agent--$273.36.

      (ii) Chemical Threat agent Analysis.

        (I) Abrine/ricinine, LC/MS-MS--$62.25.

        (II) Arsenic in urine, ICP-DRC (Dynamic reaction cell) MS--$176.62.

        (III) Cyanide in blood, gas chromatography/mass spectrometry (GC/MS)--$287.05.

        (IV) Lewisite metabolites in urine (2-chlorvinylarsonous acid (CVAA) and 2-chlorovinylarsonic acid (CVAOA), liquid chromatography, inductively coupled plasma mass spectrometry (LC-ICP-MS)--$157.59.

        (V) Metabolic Toxin Panel (monochloroacetate and monofluoro acetate in urine, LC/MS-MS)--$93.38.

        (VI) Metals in blood (mercury, lead, cadmium), inductively coupled plasma mass spectrometry (ICP/MS)--$194.64.

        (VII) Metals in urine (barium, beryllium, cadmium, lead, thallium, uranium), ICP/MS--$176.25.

        (VIII) Organophosphorus nerve agent, LC/MS-MS--$81.28.

        (IX) Tetramine, gas chromatography/mass selective detector (GC/MSD)--$183.05.

        (X) Tetranitormethane metabolite in urine (4-hydroxy-2-nitrophenylacetic acid (HNPAA)), liquid chromatography, tandem mass spectrometry (LC/MS-MS)--$62.21.

        (XI) Volatile organic compounds in blood, GC/MS--$124.85.

    (C) Mycobacteriology/mycology.

      (i) Acid fast bacilli (AFB).

        (I) Clinical specimen, AFB isolation and identification.

          (-a-) Blood culture--$138.97.

          (-b-) Culture, other than blood--$32.04.

          (-c-) Direct detection by high-performance liquid chromatography (HPLC)--$66.26.

          (-d-) Identification of AFB isolate.

            (-1-) HPLC--$124.90;

            (-2-) Accuprobe--$81.40;

            (-3-) biochemical, basic--$132.35; and

            (-4-) biochemical, complex--$472.84.

          (-e-) Nucleic acid amplification for Mycobacterium tuberculosis (M. tuberculosis) complex--$166.70.

          (-f-) Specimen concentration--$5.38.

          (-g-) Smear--$11.59.

        (II) Referred AFB isolate identification.

          (-a-) Identification, including HPLC--$133.88.

          (-b-) Biochemical identification:

            (-1-) basic--$132.35; and

            (-2-) complex--$472.84.

          (-c-) Isolate identification, Accuprobe--$81.40.

      (ii) Actinomycete, Aerobic:

        (I) Identification--$106.96; and

        (II) HPLC--$138.05.

      (iii) Fungi isolate identification:

        (I) yeast--$90.34;

        (II) mold--$65.98; and

        (III) mold by Accuprobe--$81.40.

      (iv) Mycobacterium Kansasii, Drug susceptibility, agar proportion drug, Rifampin--$185.96.

      (v) Mycobacterium tuberculosis (M. tuberculosis) complex drug susceptibility.

        (I) Agar proportion drugs.

          (-a-) Capreomycin--$30.41.

          (-b-) Ethambutol--$30.41.

          (-c-) Ethionamide--$30.41.

          (-d-) Isonaizid, 0.2 mcg/ml--$30.41.

          (-e-) Isoniazid, 1.0 mcg/ml--$30.41.

          (-f-) Kanamycin--$30.41.

          (-g-) Ofloxacin--$30.41.

          (-h-) Rifabutin--$30.41.

          (-i-) Rifampin--$30.41.

          (-j-) Streptomycin--$30.41.

        (II) MGIT drug susceptibility test: (-a) primary panel (includes Isoniazid 0.1mcg/ml and 0.4 mcg/ml, Ethambutol, and Rifampin)--$115.05; and

          (-b-) Individual MGIT primary drugs:

            (-1-) Isoniazid, 0.1 mcg/ml--$28.76.

            (-2-) Isoniazid, 0.4 mcg/ml--$28.76.

            (-3-) Ethambutol--$28.77.

            (-4-) Rifampin--$28.76.

        (III) MGIT PZA susceptibility test--$77.17.

    (D) Parasitology.

      (i) Blood parasite examination, thick and thin Giemsa--$181.79.

      (ii) Fecal ova and parasite examination, concentration and trichrome stain--$67.41.

      (iii) Malaria identification, (PCR)--$141.79.

      (iv) Miscellaneous Parasite examination:

        (I) acid fast stain--$74.17;

        (II) chromotrope stain--$140.55;

        (III) Giemsa stain--$177.55;

        (IV) tissue preparation--$73.55;

        (V) trichrome stain--$96.98; and

        (VI) wet mount--$73.55.

      (v) Parasite identification, PCR--$141.79.

      (vi) Pinworm examination--$37.50.

      (vii) Urine ova and parasite exam--$56.36.

      (viii) Worm identification:

        (I) simple--$46.44; and

        (II) complex--$120.08.

    (E) Serology.

      (i) Arbovirus:

        (I) Immmunoglobulin G (IgG) EIA:

          (-a-) Dengue--$72.15;

          (-b-) St. Louis Encephalitis--$77.26; and

          (-c-) West Nile--$77.26.

        (II) Immunoglobulin M (IgM) EIA:

          (-a-) Dengue--$58.11;

          (-b-) St. Louis Encephalitis--$107.84; and

          (-c-) West Nile--$107.84.

        (III) Immunoglobulin M (IgM) MIA (includes: St. Louis Encephalitis and West Nile Virus)--$158.20.

      (ii) Brucella IgG--$44.10.

      (iii) Cat scratch fever (Bartonella) IgG, indirect fluorescent antibody (IFA)--$95.19.

      (iv) Cytomegalovirus (CMV):

        (I) IgG--$23.23; and

        (II) IgM--$24.26.

      (v) Ehrlichia IFA--$131.31.

      (vi) Francisella tularensis:

        (I) IgG--$61.15; and

        (II) IgM--$122.30.

      (vii) Hantavirus IgG/IgM--$362.05.

      (viii) Hepatitis A:

        (I) IgM--$44.04; and

        (II) total--$34.45.

      (ix) Hepatitis B:

Cont'd...

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