Información del proveedor acerca de la COVID-19
We are closely monitoring and following all guidance from the Centers for Medicare and Medicaid (CMS) as it is released to ensure we can quickly address and support the prevention, screening, and treatment of COVID-19. As of March 18, 2020, the following guidance can be used to bill for services related to COVID-19 testing.
HCPCS and CPT Codes for COVID-19 Testing Services
- Starting April 1, 2020, providers performing the COVID-19 test can begin billing us for services that occurred after February 4, 2020, using the following newly created HCPCS codes:
- HCPCS U0001 - For CDC developed tests only - 2019-nCoV Real-Time RT-PCR Diagnostic Panel.
- HCPCS U0002 - For all other commercially available tests - 2019-nCoV Real-Time RT-PCR Diagnostic Panel.
- CPT 87635 - Effective March 13, 2020 and issued as “the industry standard for reporting of novel coronavirus tests across the nation’s health care system.”
- All member cost share (co-payment, coinsurance and/or deductible amounts) will be waived across all products for any claim billed with the new COVID-19 testing codes.
- Hemos configurado nuestros sistemas para aplicar una responsabilidad de costo compartido de $0 a los miembros para aquellos reclamos presentados utilizando estos nuevos códigos de prueba COVID-19.
- Además de la participación en el costo, se renunciará a los requisitos de autorización para cualquier reclamo recibido con estos códigos especificados.
- Los proveedores que facturen con estos códigos no estarán limitados por el tipo de proveedor y podrán ser tanto participantes como no participantes.
- Eximiremos temporalmente de los requisitos de que los proveedores de Medicare y Medicaid de otros estados estén autorizados en el estado en el que prestan los servicios cuando estén autorizados en otro estado.
- Adjudication of claims is currently planned for the first week of April 2020.
Please note: It is not yet clear if CMS will rescind the more general HCPCS Code U0002 for non-CDC laboratory tests that the Medicare claims processing system is scheduled to begin accepting starting April 1, 2020.
Medicare Reimbursement Rates for COVID-19 Testing Services for All Provider Types*
- We are complying with the rates published on March 12, 2020 by CMS:
- U0001 = $35.91
- U0002 = $51.31
- Please note: Commercial products will reimburse COVID-19 testing services in accordance with our negotiated commercial contract rates.
- Las tarifas adicionales se determinarán mediante nuevas orientaciones de los CMS y/o específicas del estado y se comunicarán cuando estén disponibles.
