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CMS NEWS
FOR IMMEDIATE RELEASE Contact: CMS Media Relations CMS
Changes Medicare Payment to Support Faster COVID-19 Diagnostic Testing Under President Trump’s leadership, the Centers for Medicare
& Medicaid Services (CMS) today announced new actions to pay for
expedited coronavirus disease 2019 (COVID-19) test results. CMS previously took action in April 2020 by increasing the
Medicare payment to laboratories for high throughput COVID-19 diagnostic
tests from approximately $51 to $100 per test. Today, CMS is announcing that
starting January 1, 2021, Medicare will pay $100 only to laboratories that
complete high throughput COVID-19 diagnostic tests within two calendar days
of the specimen being collected. Also effective January 1, 2021, for
laboratories that take longer than two days to complete these tests, Medicare
will pay a rate of $75. CMS is working to ensure that patients who test
positive for the virus are alerted quickly so they can self-isolate and
receive medical treatment. “As America continues to grapple with the COVID-19 pandemic,
prompt testing turnaround times are more important than ever,” said CMS
Administrator Seema Verma. “Today’s announcement supports faster high
throughput testing, which will allow patients and physicians to act quickly
and decisively with respect to treatment decisions, physical isolation, and
contact tracing. President Trump continues to lead the most robust testing
effort anywhere in the world.” Starting January 1, 2021, the amended Administrative Ruling (CMS
2020-1-R2) will lower the base payment amount for COVID-19 diagnostic tests
run on high-throughput technology to $75 in accordance with CMS’s assessment
of the resources needed to perform those tests. Also starting January 1,
2021, Medicare will make an additional $25 add-on payment to laboratories for
a COVID-19 diagnostic test run on high throughput technology if the
laboratory: a) completes the test in two calendar days or less, and b)
completes the majority of their COVID-19 diagnostic tests that use high
throughput technology in two calendar days or less for all of their patients
(not just their Medicare patients) in the previous month. Laboratories that
complete a majority of COVID-19 diagnostic tests run on high throughput
technology within two days will be paid $100 per test by Medicare, while
laboratories that take longer will receive $75 per test. CMS
established these requirements to support faster high throughput COVID-19
diagnostic testing and to ensure all patients (not just Medicare patients)
benefit from faster testing. These actions will be implemented under the
amended Administrative Ruling (CMS-2020-1-R2) and coding instructions for the
$25 add-on payment (HCPCS code U0005) released today. Today’s announcement builds on previous actions CMS has taken to
ensure robust laboratory testing for COVID-19. In April, CMS doubled the
payment for COVID-19 tests performed using high throughput technology to
$100. COVID-19 testing using high throughput technologies allows for
increased testing capacity using an automated process that can administer
more than 200 tests per day. The new payment amounts effective January 1,
2021 ($100 and $75) reflect the resource costs laboratories face for
completing COVID-19 diagnostic tests using high throughput technology in a
timely fashion during the Public Health Emergency. ### Get CMS
news at cms.gov/newsroom, sign up for CMS news via email and follow CMS on Twitter CMS
Administrator @SeemaCMS and @CMSgov |
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