Stay Up-to-Date: CMS Payments for COVID-19 CPT Test Codes

As states continue to reopen, and fears grow of a second wave of the disease, testing for the coronavirus has never been more crucial. To ensure you and your practice have the best information available, double-check the COVID-19 testing guidance and payments for CPT codes from the Centers for Medicare and Medicaid Services (CMS).

Updated recently, the guidance now includes payment details for the American Medical Association’s (AMA) COVID-19 testing CPT codes. CMS explains, the AMA “created CPT code 87635 for infectious agent detection by nucleic acid tests on March 13, 2020 as well as CPT codes 86769 and 86328 for serology tests on April 10, 2020. Laboratories performing these tests may bill Medicare for services that occurred after their respective effective dates.” 

The payment details CMS provides include codes U0001, U0002, 87635, 86769, and 86328, broken down according to Local Medicare Administrative Contractors (MAC) jurisdictions. Across all jurisdictions the payments sit at roughly:

U0001 - $35.91

U0002 - $51.31

87635 - $51.31

86769 - $42.13

86328 - $45.23

To view the full listing and CMS’s payment guidance, view their official statement. 

The past months have seen multiple changes to regulations and billing codes across the healthcare system as Telehealth has risen to prominence and agencies have pushed to help patients and providers during this time of need. From CMS, that recently meant raising the payments for telephone visits to match that of in-person visits, a move they made with Telehealth’s audio and visual calls earlier this year.