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CMS Increases Payment for High Throughput COVID-19 Lab Tests

April 15, 2020

McDermott+Consulting

On April 15, 2020, the Centers for Medicare and Medicaid Services (CMS) announced that they will pay $100, nearly doubling payment, for certain lab tests that use high-throughput technologies to rapidly diagnose COVID-19 cases.

Medicare will pay laboratories for the tests at $100 effective April 14, 2020, through the duration of the COVID-19 national emergency. CMS is currently paying approximately $51 for these tests. The following codes would be used to identify these tests:

  • 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

Payment for all other clinical diagnostic laboratory tests remain the same.

 

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For more information visit the McDermottPlus Payment Innovation Resource Center or contact Sheila Madhani at 202-204-1459 or smadhani@mcdermottplus.com.

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