Several types of healthcare providers can order blood work, and in most U.S. states, you can also order certain tests yourself without a provider’s involvement at all. The answer depends on where you live, what tests you need, and whether you want insurance to cover them.
Providers With Ordering Authority
The most straightforward path to blood work is through a licensed provider who is treating you for a specific medical concern. Federal guidelines from the Centers for Medicare & Medicaid Services require that the provider ordering lab tests be the one managing your care for the condition being tested. This includes several provider types:
- Physicians (MDs and DOs) have full authority to order any laboratory test in all 50 states.
- Nurse practitioners (NPs) can order blood work in every state, though some states require a collaborative agreement with a physician.
- Physician assistants (PAs) also have ordering authority nationwide, typically under a supervisory or collaborative arrangement with a physician.
- Certified nurse midwives can order lab tests related to their scope of practice, including prenatal panels and routine screenings.
In practical terms, if you have a primary care provider of any of these types, they can order virtually any blood test you need. The key federal requirement is that the provider ordering the test is actively involved in your care and will use the results to manage your health.
Chiropractors and Other Specialists
Chiropractors can order blood work in some states, but their authority is limited to specific tests. In New York, for example, the state education department maintains an approved list of clinical laboratory tests that licensed chiropractors may order, covering areas like nutritional markers and basic metabolic panels. Other states have their own rules, and some don’t grant chiropractors any lab ordering authority. If you see a chiropractor who recommends blood work, ask whether they can order it directly or whether you’ll need a referral to another provider.
Pharmacists Under Collaborative Agreements
Pharmacists in many states can order and perform certain lab tests, but this typically requires a collaborative practice agreement with a prescriber. These agreements specifically delegate testing responsibilities to the pharmacist. The scope varies widely by state. Some states allow pharmacists broad latitude to order diagnostic blood tests, while others limit them to point-of-care screenings like blood glucose or cholesterol checks. Your local pharmacy chain may offer basic health screenings that fall under this authority.
Ordering Your Own Blood Work
You don’t always need a provider to get blood work done. Currently, 37 states and the District of Columbia allow consumers to order some or all laboratory tests directly, without going through a healthcare provider. These are called direct-access testing or direct-to-consumer testing laws, and they’ve made self-ordered blood work increasingly common.
The process through major commercial labs like Quest Diagnostics is straightforward. You browse available tests online, purchase the one you want, then schedule an appointment at a nearby lab location for a blood draw. Results typically come back through an online portal, and many services include a consultation with an independent healthcare provider at no extra cost to help you interpret what the numbers mean.
You have a few options for how the sample gets collected. You can visit one of thousands of lab locations in person, pay an additional fee (around $79 at Quest) to have a phlebotomist come to your home, or use a mail-in home collection kit for certain tests. No doctor visit and no health insurance are required to purchase these tests.
Prices vary significantly depending on what you’re testing. A single marker like an aluminum test might cost around $52, while a comprehensive panel like a core vitamin and micronutrient test runs about $190 to $240. Broader panels that cover cholesterol, metabolic function, and inflammation markers can cost $250 to $450. These are out-of-pocket costs since insurance generally doesn’t cover self-ordered tests.
Telehealth Providers
Telehealth platforms offer another route to getting blood work ordered without an in-person visit. A provider on a telehealth platform can order lab tests just like one you’d see in an office, as long as they hold the right credentials and are licensed in your state. After a virtual consultation, the provider sends the lab order electronically, and you visit a local lab for the blood draw. Many people use this approach when they want specific tests their regular provider hasn’t offered, or when they don’t have an established primary care relationship.
The provider on the other end of the screen still needs to be a physician, nurse practitioner, or physician assistant treating you for the relevant concern. A quick video or phone consultation satisfies this requirement in most cases.
Insurance Coverage and Medical Necessity
Who orders your blood work matters for insurance purposes. For a test to be covered, it generally needs to be ordered by a treating provider and tied to a specific medical reason. CMS rules specify that the ordering provider must be managing your care for the condition being investigated. A routine cholesterol check ordered by your primary care doctor during an annual physical meets this standard easily. A self-ordered test purchased through a direct-to-consumer lab does not.
If you’re paying out of pocket, this distinction doesn’t matter. But if you want insurance to pick up the tab, the test needs to come through a provider who documents why it’s medically necessary. This is one of the main trade-offs of direct-to-consumer testing: convenience and autonomy in exchange for absorbing the full cost yourself.
For states that don’t allow direct-access testing, your options are limited to getting an order from a licensed provider, whether that’s in person or through telehealth. If you’re unsure about your state’s rules, the simplest workaround is a telehealth visit, which can often be completed in under 15 minutes and results in a standard lab order that any nearby facility will accept.