Precision Psychiatric Lab Testing

Evidence-based laboratory monitoring to optimize your mental health treatment. Every test is backed by research and tailored to your psychiatric care. Transparent pricing — no surprises.

AJ Anderson, APRN, PMHNP-BC, LCSW • Azimuth Therapeutics, LLC
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With Insurance

Why Lab Testing Matters in Psychiatry

Psychiatric medications affect your entire body, not just your brain. Comprehensive lab monitoring ensures your medications are working safely, identifies hidden causes of your symptoms, and enables a precision approach to your mental health care. As a Connecticut APRN with full independent practice authority, I can order all medically necessary laboratory tests directly.

Your Estimated Lab Costs

M Metabolic Monitoring

Essential for patients on psychiatric medications, especially antipsychotics

Comprehensive Metabolic Panel (CMP)

CPT 80053
Monitors electrolytes, kidney function, liver function, and glucose. Essential baseline for ALL patients starting psychiatric medications.
Key for: All patients on psychiatric meds, especially antipsychotics, lithium, valproate
Frequency: Baseline, 3 months, 6 months, then annually
Cash Pay
$10 – $15
Quest / Ulta Labs direct
With Insurance
$0 – $5
Typically covered — preventive
Quest
$10
Ulta Labs
$12
Hospital
$50-150
Included Interpretation included with medication monitoring — standard of care
ADA/APA Consensus Statement 2004; Maudsley Prescribing Guidelines 14th Ed.

Lipid Panel (Complete)

CPT 80061
Cholesterol and triglycerides. Antipsychotics like olanzapine and clozapine increase triglycerides by 20–40% from baseline.
Key for: All patients on SGAs (olanzapine, clozapine, quetiapine, risperidone)
Frequency: Baseline, 3 months, then annually
Cash Pay
$10 – $20
With Insurance
$0
Covered preventive for ages 20+
Included Interpretation included — required for antipsychotic monitoring
ADA/APA Consensus 2004; CANMAT 2018; Hjorthoj et al., Lancet Psychiatry 2017

HbA1c (Glycated Hemoglobin)

CPT 83036
Your 3-month glucose average. Patients on antipsychotics have 2–3x increased risk of Type 2 diabetes.
Key for: All SGA patients, metabolic syndrome, weight gain, prediabetes screening
Frequency: Baseline, 3 months, annually
Cash Pay
$15 – $25
With Insurance
$0 – $10
Covered for metabolic screening
Included Interpretation included — metabolic risk monitoring
ADA Standards of Care 2024; Correll et al., JAMA Psychiatry 2015

T Thyroid Function

Thyroid dysfunction mimics — and worsens — psychiatric conditions

TSH + Free T4 + Free T3

CPT 84443, 84439, 84481
Complete thyroid panel. Hypothyroidism is present in 10–15% of patients with depressive symptoms. Lithium causes hypothyroidism in 20–30% of patients.
Key for: Depression, bipolar disorder, lithium use, fatigue, cognitive complaints
Frequency: Baseline, q6mo (annually stable; q3mo on lithium)
Cash Pay
$30 – $50
With Insurance
$0 – $15
Usually covered with dx code
$25 Standard interpretation — clinical correlation with mood symptoms
APA Practice Guidelines; McKnight et al., Lancet 2012

Thyroid Antibodies (TPO, TG)

CPT 86376, 86800
Identifies autoimmune thyroiditis (Hashimoto's), associated with 3.56x increased depression risk even when TSH is normal.
Key for: Depression with thyroid symptoms, family history autoimmune, treatment-resistant depression
Frequency: Baseline if thyroid symptoms; as needed
Cash Pay
$25 – $40
With Insurance
$0 – $20
Covered with clinical indication
$25 Standard interpretation
Pop et al., 1998; Carta et al., 2004

V Vitamin & Nutrient Levels

Nutritional deficiencies are treatable causes of depression, anxiety, and cognitive dysfunction

Vitamin D, 25-Hydroxy

CPT 82306
42% of US adults are deficient. Vitamin D deficiency is linked to a 2.21-fold (Anglin et al., 2013) increased risk of depression.
Key for: Depression, seasonal affective disorder, fatigue, cognitive complaints
Frequency: Baseline, annually; q3mo if supplementing
Cash Pay
$15 – $30
With Insurance
$0 – $25
Often covered; some plans limit
$45 Comprehensive interpretation — supplement protocol + dietary guidance
Anglin et al., Br J Psychiatry 2013

Vitamin B12 & Folate

CPT 82607, 82746
B12 deficiency may present with depressive symptoms, psychosis, and cognitive decline. Folate deficiency linked to treatment-resistant depression — L-methylfolate augmentation has modest supporting evidence (Maruf et al., 2022).
Key for: Depression, cognitive decline, vegetarian/vegan patients, metformin/PPI users
Frequency: Baseline, annually
Cash Pay
$20 – $35
With Insurance
$0 – $15
Usually covered with dx code
$45 Comprehensive interpretation — methylation status + supplementation plan
Papakostas et al., Am J Psychiatry 2012

Iron / Ferritin Panel

CPT 83540, 82728
Low ferritin linked to depression, restless leg syndrome, and ADHD. Ferritin <30 may cause psychiatric symptoms even with normal hemoglobin.
Key for: Depression, fatigue, restless legs, ADHD, heavy menstruation
Frequency: Baseline; as clinically indicated
Cash Pay
$10 – $20
With Insurance
$0 – $10
Covered with anemia/fatigue dx
$45 Comprehensive interpretation — clinical correlation + treatment plan
Earley et al., Sleep Med Rev 2014; Konofal et al., 2008

H Hormones

Hormonal imbalances directly impact mood, energy, and cognitive function

Testosterone (Total & Free)

CPT 84403, 84402
Low testosterone linked to depression, fatigue, decreased motivation, and cognitive decline, especially in men over 40.
Key for: Depression in men >40, low libido, fatigue, cognitive decline
Frequency: Baseline if symptoms; q6-12mo if treating
Cash Pay
$20 – $40
With Insurance
$0 – $30
Covered with clinical indication
$45 Comprehensive interpretation — hormonal-mood correlation + referral if needed
Zarrouf et al., J Psychiatr Pract 2009

Prolactin

CPT 84146
Elevated by antipsychotics (risperidone 70–100% of patients). Causes sexual dysfunction, amenorrhea, galactorrhea, and long-term osteoporosis risk.
Key for: All antipsychotic patients, sexual dysfunction, amenorrhea
Frequency: Baseline, 3 months, annually on antipsychotics
Cash Pay
$15 – $25
With Insurance
$0 – $10
Covered — medication monitoring
Included Interpretation included — required antipsychotic monitoring
Maudsley Guidelines; Haddad & Wieck, 2004

I Inflammatory Markers

Chronic inflammation is increasingly recognized as a driver of treatment-resistant depression

hs-CRP (High-Sensitivity C-Reactive Protein)

CPT 86141
Elevated CRP (>3 mg/L) predicts poor antidepressant response. Patients with high CRP may respond better to anti-inflammatory augmentation or specific antidepressants like bupropion.
Key for: Treatment-resistant depression, fatigue-predominant depression, metabolic syndrome
Frequency: Baseline, annually
Cash Pay
$10 – $25
With Insurance
$0 – $15
Usually covered with cardiac/metabolic dx
$45 Comprehensive — inflammation-mood analysis + treatment implications
Raison et al., JAMA Psychiatry 2013; Chamberlain et al., Mol Psychiatry 2019

R Medication Monitoring

Drug levels and safety labs required by FDA labeling and clinical guidelines

CBC with Differential

CPT 85025
Required for clozapine monitoring (REMS program). Also monitors for medication-induced blood dyscrasias.
Key for: Clozapine (mandatory), carbamazepine, valproate
Frequency: Weekly x6mo, biweekly x6mo, then monthly (clozapine); baseline + PRN (others)
Cash Pay
$15 – $25
With Insurance
$0
Covered — FDA-required monitoring
Included Interpretation included — mandatory safety monitoring
FDA Clozapine REMS; Maudsley Guidelines

Lithium Level

CPT 80178
Narrow therapeutic index (0.6–1.2 mEq/L). Toxicity is life-threatening. Regular monitoring is the standard of care.
Key for: All patients on lithium
Frequency: 2–3x weekly until stable, then q3-6mo
Cash Pay
$15 – $30
With Insurance
$0
Always covered — medically necessary
Included Interpretation included — required drug level monitoring
APA Bipolar Guidelines; Malhi et al., ISBD 2020

Valproate / Carbamazepine Levels

CPT 80164 / 80156
Therapeutic drug monitoring ensures efficacy (50–125 mcg/mL for valproate) and prevents hepatotoxicity and pancreatitis.
Key for: All patients on valproic acid/divalproex or carbamazepine
Frequency: q1-2 weeks until stable, then q3-6mo
Cash Pay
$15 – $30
With Insurance
$0
Always covered — required monitoring
Included Interpretation included — drug level + hepatic monitoring
APA Practice Guidelines; FDA prescribing information

Genetic & Pharmacogenomic Testing

Your DNA determines how you metabolize medications — one test, lifetime guidance. Stop the trial-and-error.

GeneSight Psychotropic

12+ Genes • CPT 81479
Tests CYP450 enzymes and pharmacodynamic genes to guide antidepressant, antipsychotic, and mood stabilizer selection. Categorizes medications into green/yellow/red based on your metabolism. One-time test with lifetime results.
Cash Pay (Max)
$330
Manufacturer cap — financial aid available
With Insurance
Often $0
Most commercial plans + Medicare cover
Ideal for: Treatment-resistant depression, 2+ medication failures, polypharmacy, significant side effects
$75 Specialty interpretation — full pharmacogenomic consultation (30 min)
GUIDED RCT (Am J Psychiatry 2019): 26% vs 19.9% response; 15.3% vs 10.1% remission
Learn More

Genomind Professional PGx Express

24 Genes • CPT 81479
Broader 24-gene panel covering pharmacokinetic AND pharmacodynamic genes. Includes mental health-specific markers beyond CYP450: serotonin transporter, COMT, MTHFR, HLA-A/B (for Stevens-Johnson risk). Actionable report with specific medication recommendations.
Cash Pay
$399 – $599
Financial assistance programs available
With Insurance
$0 – $150
Prior auth may be required
Ideal for: Complex psychiatric presentations, ADHD + anxiety combos, wanting the deepest genetic insight
$75 Specialty interpretation — full pharmacogenomic consultation (30 min)
Hall-Flavin et al., Pharmacogenomics 2013; CPIC Guidelines
Learn More

MTHFR & Methylation Panel

1–3 Genes • CPT 81291
Tests for MTHFR C677T and A1298C variants that affect folate metabolism and methylation. Impaired methylation can reduce the effectiveness of antidepressants. Guides L-methylfolate supplementation (Deplin, EnLyte).
Cash Pay
$50 – $150
Quest / direct lab
With Insurance
$0 – $50
Coverage varies by plan
Ideal for: Treatment-resistant depression, poor response to SSRIs, family history of mood disorders
$75 Specialty interpretation — methylation analysis + supplementation protocol
Papakostas et al., Am J Psychiatry 2012; Fava & Mischoulon, 2009
Order via Quest

S Toxicology, Substance Use & Addiction Monitoring

Comprehensive screening and monitoring for substance use disorders and safe prescribing

Urine Drug Screen (UDS)

CPT 80307
Baseline and monitoring tool for patients prescribed controlled substances. Also identifies unreported substance use that may impact treatment planning.
Key for: Controlled substance prescribing, SUD assessment, treatment-resistant presentations
Frequency: Baseline, q1-3mo for controlled substances, PRN
Cash Pay
$20 – $40
With Insurance
$0 – $15
Covered for substance monitoring
Included Interpretation included — prescribing safety standard
ASAM Guidelines; DEA prescriber obligations

Ethanol Level & GGT

CPT 80320, 82977
GGT is the most sensitive marker for chronic alcohol use. Elevated GGT with normal ALT/AST suggests alcohol-specific liver injury. Ethanol level confirms acute intoxication when needed clinically.
Key for: Alcohol use disorder, monitoring sobriety, liver function in chronic drinkers
Frequency: Baseline, monthly during early recovery, q3-6mo stable
Cash Pay
$15 – $25
With Insurance
$0 – $10
Covered with SUD diagnosis
Included Interpretation included — substance use monitoring
ASAM Criteria; NIAAA Clinician’s Guide

CDT (Carbohydrate-Deficient Transferrin)

CPT 82373
Gold-standard biomarker for heavy alcohol use (4+ drinks/day for 2+ weeks). More specific than GGT. Useful for monitoring treatment compliance in alcohol use disorder.
Key for: Alcohol use disorder confirmation, monitoring abstinence, relapse detection
Frequency: Baseline, q2-4 weeks early recovery, q3mo maintenance
Cash Pay
$25 – $45
With Insurance
$0 – $20
Covered with AUD diagnosis
$25 Standard interpretation — recovery progress tracking
Niemelä et al., Clin Chem 2016; ASAM Guidelines

Phosphatidylethanol (PEth)

CPT 80299
Direct alcohol biomarker with a 3–4 week detection window. Detects any alcohol consumption, not just heavy use. Cannot be faked or diluted. Increasingly used in clinical monitoring programs.
Key for: Monitoring abstinence programs, court-ordered testing, relapse prevention
Frequency: q2-4 weeks during active monitoring
Cash Pay
$15 – $30
With Insurance
$0 – $15
Coverage varies by plan
$25 Standard interpretation — abstinence verification
Helander & Hansson, Clin Chem 2022

Ammonia Level

CPT 82140
Hyperammonemia can cause psychiatric symptoms including confusion, lethargy, and personality changes. Valproate causes hyperammonemia in up to 50% of patients, sometimes without liver enzyme elevation. Also essential in alcoholic liver disease and hepatic encephalopathy.
Key for: Valproate use, alcoholic liver disease, unexplained cognitive decline, altered mental status, cirrhosis
Frequency: Baseline on valproate, PRN for cognitive changes, monitoring in liver disease
Cash Pay
$10 – $20
With Insurance
$0 – $10
Covered — medication monitoring
Included Interpretation included — medication safety monitoring
Carr & Shread, 2010; Maudsley Guidelines

Hepatic Function Panel & MCV

CPT 80076, 85025
Comprehensive liver assessment for substance use monitoring. AST:ALT ratio >2:1 is characteristic of alcoholic liver disease. Elevated MCV (macrocytosis) is a long-term marker of heavy alcohol use and B12/folate deficiency common in addiction.
Key for: Alcohol use disorder, IV drug use (hepatitis risk), polysubstance use, medication hepatotoxicity
Frequency: Baseline, q3-6mo during recovery, annually stable
Cash Pay
$30 – $60
With Insurance
$0 – $15
Covered with clinical indication
$45 Comprehensive — substance use liver profile + nutritional assessment
AASLD Guidelines; WHO Alcohol Screening

Urine Ethyl Glucuronide (EtG)

CPT 80321
Detects alcohol metabolite for 48–72 hours after last drink. Highly sensitive — can detect even small amounts of alcohol exposure. Standard in professional monitoring and recovery programs.
Key for: Recovery monitoring, professional licensing programs, zero-tolerance verification
Frequency: Random or scheduled per monitoring program
Cash Pay
$15 – $30
With Insurance
$0 – $15
Coverage varies
$25 Standard interpretation
Helander et al., Clin Chem 2009; SAMHSA TIP 60

D Infectious Disease Screening

Infections that cause psychiatric symptoms — especially relevant in CT (Lyme endemic area)

Lyme Disease Panel

CPT 86617
Connecticut is the #1 Lyme-endemic state. Neuropsychiatric Lyme can cause depression, cognitive impairment, anxiety, and psychosis.
Key for: New-onset psychiatric symptoms, cognitive complaints, fatigue, joint pain + mood changes
Frequency: As needed (endemic area — low threshold to test)
Cash Pay
$15 – $30
With Insurance
$0 – $10
Covered in endemic areas with symptoms
$25 Standard interpretation — neuropsychiatric Lyme assessment
Fallon et al., Am J Psychiatry 2008

RPR / Syphilis Screen

CPT 86592
Neurosyphilis causes psychiatric symptoms including personality change, psychosis, and dementia. Treatable if caught.
Key for: New-onset psychiatric symptoms, cognitive changes, first-episode psychosis
Frequency: Baseline for new-onset psychiatric symptoms
Cash Pay
$10 – $25
With Insurance
$0
Covered as preventive screening
$25 Standard interpretation
APA First-Episode Psychosis Guidelines

A Autoimmune & Neuro Screening

Autoimmune conditions increasingly recognized as causes of psychiatric symptoms

ANA (Antinuclear Antibodies)

CPT 86038
Screens for lupus and other autoimmune conditions. Neuropsychiatric lupus may present with depressive symptoms, psychosis, cognitive dysfunction, and seizures.
Key for: Psychosis with physical symptoms, young women with new-onset depression + fatigue/joint pain
Frequency: Baseline if autoimmune symptoms; PRN
Cash Pay
$15 – $30
With Insurance
$0 – $15
Covered with clinical indication
$45 Comprehensive interpretation — autoimmune-psychiatric correlation
Unterman et al., Semin Arthritis Rheum 2011

14-3-3 Protein & RT-QuIC (Prion Disease)

CPT 86235, 83519
Gold-standard screening for prion diseases (Creutzfeldt-Jakob disease). CJD can present with rapidly progressive psychiatric symptoms including personality changes, depression, psychosis, and cognitive decline that may initially be misdiagnosed as psychiatric illness. RT-QuIC assay has 92–97% sensitivity and near-100% specificity.
Key for: Rapidly progressive dementia, unexplained neuropsychiatric decline, myoclonus + cognitive symptoms, atypical early-onset dementia
Frequency: One-time diagnostic workup (CSF required — referral to neurology for lumbar puncture)
Cash Pay
$200 – $500
Reference lab (NPDPSC / Quest)
With Insurance
$0 – $100
Covered with neurological indication
$75 Specialty interpretation — coordinated with neurology referral
McGuire et al., Ann Neurol 2012; CDC CJD Diagnostic Criteria; NPDPSC Guidelines

Continuous Glucose Monitoring (CGM)

Real-time blood sugar tracking reveals the hidden metabolic drivers of mood instability

FreeStyle Libre 3 (Abbott)

Cash Pay
$70 – $99/sensor
With Insurance
$0 – $20/sensor
With diabetes/prediabetes dx
14-day continuous monitoring. World's smallest sensor. Real-time glucose readings via smartphone. Over 95% of private insurance covers with diabetes diagnosis.
For psychiatric patients: APRN can prescribe. Best path for insurance coverage: screen for prediabetes first (HbA1c 5.7–6.4%).
$75/cycle CGM data interpretation — glucose-mood correlation analysis (30 min)
Learn More

Dexcom G7

Cash Pay
$300 – $400/mo
With Insurance
$89 – $210/mo
With diabetes dx + prior auth
10-day sensor with real-time alerts for high/low glucose. Apple Watch integration. Superior alert system for detecting dangerous glucose drops.
For psychiatric patients: Premium option. Best for patients on medications with highest metabolic risk (clozapine, olanzapine).
$75/cycle CGM data interpretation — glucose-mood correlation analysis (30 min)
Learn More

Wellness CGM (No Rx Needed)

Subscription
$149 – $249/mo
Insurance
Not Covered
Wellness / self-pay only
Programs like Levels and Nutrisense include CGM sensors + app-based tracking, coaching, and educational content. No prescription required.
For psychiatric patients: Best for health-conscious, self-pay patients who want to correlate glucose with mood/energy/sleep.
$75/cycle CGM data interpretation — glucose-mood correlation analysis (30 min)
Levels Nutrisense

Lab Interpretation Fee Structure

Our fees reflect the actual clinical time required to review, correlate with your psychiatric condition, and translate results into an actionable treatment plan. Tests required for medication safety are always included at no additional charge.

Included in Your Visit

$0
~2–5 minutes per result
Labs that are required for safe medication prescribing. These are standard of care — interpretation is built into your visit fee. We don't charge extra for doing what good medicine requires.
  • CMP, BMP (electrolytes, kidney, liver)
  • CBC (blood counts, clozapine monitoring)
  • Lithium, valproate, carbamazepine levels
  • Lipid panel (antipsychotic metabolic monitoring)
  • HbA1c (metabolic screening)
  • Prolactin (antipsychotic monitoring)
  • Hepatic function panel
  • UDS (prescribing safety)

Standard Interpretation

$25
~5–10 minutes per result
Diagnostic labs ordered to rule out medical causes of psychiatric symptoms. Requires clinical correlation between lab values and your mental health presentation.
  • TSH, Free T4, Free T3 (thyroid panel)
  • Thyroid antibodies (TPO, TG)
  • Lyme disease panel
  • RPR / syphilis screen
  • HIV screening
  • Hepatitis panel

Comprehensive Interpretation

$45
~10–20 minutes per result
Wellness and optimization labs that require deeper analysis, clinical correlation with mood and functional status, and a personalized treatment or supplementation plan.
  • Vitamin D + supplementation protocol
  • B12 & folate + methylation analysis
  • Iron / ferritin + treatment plan
  • Testosterone + hormonal-mood correlation
  • Cortisol (HPA axis assessment)
  • hs-CRP (inflammation-mood analysis)
  • ANA (autoimmune-psychiatric screen)
  • Magnesium, zinc, omega-3 index

Specialty Interpretation

$75
~30 minutes consultation
Complex results that require dedicated review time, cross-referencing with your medication regimen, and a detailed consultation to walk you through findings and treatment changes.
  • GeneSight pharmacogenomic results
  • Genomind PGx Express results
  • MTHFR / methylation panel
  • CGM data review (per sensor cycle)
  • Comprehensive panel review (5+ tests)
Membership benefit: Premier and Bespoke members receive up to 2 comprehensive and 1 specialty interpretation per quarter included in their membership. All members receive unlimited included-tier interpretations at no additional cost.

The Evidence: Lab Testing & Mental Health

Depression & Glucose Variability

Anhedonia is positively associated with multiple markers of metabolic dysfunction including glucose levels, with consistent effects over 6-year follow-up.

Zwiep et al., Brain Behav Immun, 2025

Pharmacogenomics & Treatment Response

Gene-guided prescribing showed 26% response vs 19.9% response, and 15.3% remission vs 10.1% remission in the landmark GUIDED randomized controlled trial.

Greden et al., Am J Psychiatry, 2019

Vitamin D & Depression

Vitamin D deficiency is associated with a 2.21-fold increased risk of depression. 42% of US adults are deficient, with higher rates in psychiatric populations.

Anglin et al., Br J Psychiatry, 2013

Inflammation & Antidepressant Response

Elevated CRP (>3 mg/L) predicts poor response to standard antidepressants and suggests benefit from anti-inflammatory augmentation strategies.

Raison et al., JAMA Psychiatry, 2013

Antipsychotic Metabolic Risk

Clozapine: 4.45 kg weight gain at 10 weeks. Olanzapine: 4.15 kg. Both increase triglycerides 20–40% from baseline. Metabolic monitoring is the standard of care.

ADA/APA Consensus Statement; Lancet Psychiatry Meta-Analysis

MTHFR & Treatment Resistance

L-methylfolate 15mg augmentation significantly improved symptoms in SSRI-resistant depression, with a response rate of 32.3% vs 14.6% placebo.

Papakostas et al., Am J Psychiatry, 2012

A Note on Insurance & Lab Costs

Azimuth is a cash-pay concierge practice. However, many of the lab tests we order are independently covered by your health insurance — an unexpected perk of having a provider who orders with proper diagnostic coding.

Labs Are Separate from Your Membership

Lab draw and processing fees are paid directly to the laboratory (Quest, Ulta Labs, etc.), not to Azimuth. When ordered with appropriate ICD-10 diagnostic codes, many insurance plans cover these lab costs at no additional charge to you.

Transparent Cash-Pay Options

We partner with labs offering significantly discounted cash-pay pricing — often 70–90% less than hospital rates. A comprehensive psychiatric workup can cost as little as $85–200 out of pocket through Quest or Ulta Labs direct pricing.

We Order with Proper Coding

Every lab we order includes appropriate diagnostic codes and medical necessity justification. While we can’t guarantee your insurance will cover any given test, proper coding gives you the best chance at coverage.

Important Notice: This page is for informational purposes only. All laboratory tests must be ordered by a licensed healthcare provider based on individual clinical assessment. Test selection, frequency, and interpretation should be guided by your provider based on your specific diagnosis, medications, and medical history. Pricing is approximate and subject to change. Insurance coverage varies by plan. Interpretation fees are separate from lab draw and processing fees. This page does not constitute medical advice.

Ready for Precision Psychiatric Care?

Comprehensive lab monitoring is integrated into all Azimuth membership tiers. Schedule a consultation to discuss which tests are right for you.

Call (203) 718-6513