Active Feature Acquisition (AFA) adaptively selects which diagnostic test to order next and offers a route to reduce unnecessary laboratory testing in acute care. Existing clinical AFA evaluations, however, assume every feature can be retrieved on demand and split data at the visit level, both of which inflate apparent performance. We re-evaluate cost-aware AFA under constraints designed to reflect deployment. From MIMIC-IV we constructed a cohort of 64,766 acute admissions (39,884 patients; 21 conditions; 55 features in 30 test panels) with a patient-level split, a 12-hour decision cutoff, and a per-patient availability mask from what was actually measured, and priced panels using the 2026 Medicare fee schedule under panel-level billing. We evaluated EIG-Cost, which scores each panel by Monte-Carlo Expected Information Gain penalised by its dollar cost, against eight published methods across budgets 30--$60 over five patient-level resamples. At a $30 budget, EIG-Cost achieved the highest macro-F1 (0.188, 95% CI [0.185, 0.191]) at the lowest cost ($17.28), exceeding the strongest baseline in all five resamples (p