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FOR
IMMEDIATE RELEASE
April
16, 2020
Contact:
CMS Media Relations
CMS
Increases Medicare Payment for High-Production Coronavirus Lab Tests
CMS
helps expand testing capacity and monitoring for COVID-19 in nursing
homes and other settings with high volume testing needs
Under
President Trump’s leadership, the Centers for Medicare & Medicaid
Services (CMS) today announced Medicare will nearly double payment for
certain lab tests that use high-throughput technologies to rapidly diagnose
large numbers of 2019 Novel Coronavirus (COVID-19) cases. This is another
action the Trump Administration is taking to rapidly expand COVID-19
testing, particularly for those with Medicare, including nursing home
residents who are among the most vulnerable to COVID-19 and most affected
by COVID-19 outbreaks across the country.
“CMS
has made a critical move to ensure adequate reimbursement for advanced
technology that can process a large volume of COVID-19 tests rapidly and
accurately,” said CMS Administrator Seema Verma. “This is an absolute
game-changer for nursing homes, where risk of Coronavirus infection is
high among our most vulnerable.”
Medicare
will pay the higher payment of $100 for COVID-19 clinical diagnostic lab
tests making use of high-throughput technologies developed by the private
sector that allow for increased testing capacity, faster results, and
more effective means of combating the spread of the virus.
High-throughput lab tests can process more than two hundred specimens a
day using highly sophisticated equipment that requires specially trained
technicians and more time-intensive processes to assure quality. Medicare
will pay laboratories for the tests at $100 effective April 14, 2020,
through the duration of the COVID-19 national emergency.
Increasing
Medicare payment for these tests will help laboratories test in nursing
home communities that are vulnerable to the spread of COVID-19. On March
30, 2020, CMS announced that Medicare will pay new specimen collection
fees for COVID-19 testing for homebound and non-hospital inpatients, to
help facilitate the testing of homebound individuals and those unable to
travel. As a result of these actions, laboratories will have expanded
capability to test more vulnerable populations, like nursing home
patients, quickly and provide results faster.
For
other COVID-19 laboratory tests, local Medicare Administrative
Contractors (MACs) remain responsible for developing the payment amount
in their respective jurisdictions. MACs are currently paying approximately
$51 for those tests. As with other laboratory tests, there is generally
no beneficiary cost-sharing under Original Medicare.
This
announcement builds upon recent CMS actions to expand testing for
COVID-19. On March 30, 2020, CMS announced that hospitals, laboratories,
and other entities can perform tests for COVID-19 on people at home and
in other community-based settings outside of the hospital. This will both
increase access to testing and reduce risks of exposure. Additionally,
CMS took action to allow healthcare systems, hospitals, and communities
to set up testing sites to identify COVID-19-positive patients in a safe
environment.
Increasing
Medicare payment for tests that use high-throughput technologies, and
earlier CMS actions in response to COVID-19, are part of the ongoing
White House Coronavirus Task Force efforts. To keep up with the important
work the Task Force is doing in response to COVID-19, visit www.coronavirus.gov. For a complete and
updated list of CMS actions, and other information specific to CMS,
please visit the Current Emergencies Website.
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