diagnostic

CMS announces higher pricing for certain COVID-19 tests

April 15, 2020

McDermott+Consulting

CMS has increased pricing for COVID-19 lab tests that use high-throughput technologies to rapidly diagnose large numbers of potential COVID-19 cases. Effective April 14, 2020, CMS will pay $100 (nearly double the current price) for COVID-19 clinical diagnostic lab tests making use of high-throughput technologies developed by the private sector that allow for increased testing capacity.

CMS also created two new HCPCS codes as a way to identify tests performed on high-throughput technology.

U0003 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies as described by CMS-2020-01-R
U0004 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-01-R

U0003 should be used for tests that would otherwise be reported under 87635 while U0004 should be used for tests that would otherwise be reported under U0002.

CMS-Ruling 2020-1-R

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