The Centers for Medicare & Medicaid Services (CMS) announced it is updating its payment policies for high-throughput COVID-19 testing to encourage faster results.
In April 2020, CMS first ruled that it would pay $100 for clinical diagnostic lab tests that use high-throughput technologies for detecting COVID-19 (details). In today’s updated ruling, CMS now states it will begin paying $100 only to laboratories that complete high-throughput tests within two calendar days of the specimen being collected. CMS adds that, for labs to receive the $100 payment, they must also have completed a majority of high-throughput tests for COVID-19 within two days in the previous month for all patients (i.e., not just Medicare patients). For labs that take longer than two days to complete these tests, CMS says it will pay $75.
The $25 add-on payment that will constitute the full $100 payment is associated with HCPCS code U0005.
CMS states these policies will go into effect beginning January 1, 2021. The agency adds it is updating its payment policies to “ensure that patients who test positive for the virus are alerted quickly so they can self-isolate and receive medical treatment.”