The rates that providers and laboratories charge for COVID-19 diagnostic and antibody testing — prices that "have important implications for out-of-network plans, uninsured patients, and other payers with little negotiating power" because of provisions in the CARES Act — far exceeded their Medicare reimbursement rates, according to a recent study published in the Society of General Internal Medicine. By analyzing administrative claims data from the COVID-19 Research Database, the study found that independent labs — which performed almost half of all COVID-19 diagnostic tests — charged $140.41 on average, while the Medicare rate was $51.31. Independent labs performed more than 95% of all antibody tests, with an average charge of $62.30, compared to the Medicare rate of $42.13. Across the country, average diagnostic testing fees ranged by state, from a low of $64.98 in Utah to a high of $505.65 in Washington, D.C. For antibody testing, New Mexico providers and labs charged an average of $195.41, more than four times of the average charge in New York ($45.85).
NOTES: States that had 10 or fewer claims were classified as
"no data." This study was funded by Arnold Ventures.
SOURCE: "Charges of COVID-19 Diagnostic Testing and Antibody Testing
Across Facility Types and States," Society of General Internal Medicine
2020, DOI: 10.1007/s11606-020-06198-y. Visit https://bit.ly/32WJtEH.
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