CMS Identifies Billing Codes for Coronavirus Testing

Publication Date: Mar 6, 2020

ASCP is pleased to report that the Centers for Medicare & Medicaid Services (CMS) has developed two new Healthcare Common Procedure Coding System (HCPCS) codes to allow clinical laboratories to bill for testing related to the novel Coronavirus Diseases-2019 (COVID-2019) outbreak. The first code, U0001, announced on February 13, is for the performance of the “Centers for Disease Control and Prevention (CDC) 2019 novel Coronavirus Real-Time RT-PCR Diagnostic Test Panel.” The second HCPCS code, U0002, allows clinical laboratories to bill for “non-CDC laboratory tests for SARS-CoV-2/2019-nCoV (COVID-19)”, such as those the laboratory may have developed themselves. Per FDA’s February 29 guidance, clinical laboratories that are authorized to perform high complexity testing may develop and use their own diagnostics, once they have been validated in accordance the Clinical Laboratory Improvement Amendments (CLIA). The new codes, “allow those labs conducting the test to bill for the specific test instead of using an unspecified code, which means better tracking of the public health response for this particular strain of the coronavirus to help protect people from the spread of this infectious disease.” According to CMS, “local Medicare Administrative Contractors are responsible for developing the payment amount for claims they receive for these newly created HCPCS codes…until CMS establishes national payment rates." The Medicare claims processing system will be able to accept this code on April 1 for dates of service on or after February 4.

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