CMS Issues A Second Billing Code for COVID-19 Testing

On March 6, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a second Healthcare Common Procedure Coding System (HCPCS) code to be used by laboratories for the testing and tracking of new cases of the 2019-Novel Coronavirus disease (COVID-19).  The code will be available for use starting April 1 with retroactive effect to February 4, 2020.

This move follows last month’s publication of the first HCPCS code to bill for testing for SARS-CoV-2, the virus causing COVID-19. The first code is for use only by CDC-testing laboratories. The second HCPCS code is for use by laboratories utilizing non-CDC laboratory tests for COVID-19 and for certain laboratories authorized to develop their own validated tests.  

Issuance of these new codes is expected to encourage more widespread testing and improve tracking of the disease. Medicare Administrative Contractors will set the payment amount for claims utilizing the two HCPCS codes until such time as national payment rates are set by CMS.

These latest developments appear part of a broader CMS effort to address COVID-19-related concerns. As discussed in other Health Care Counsel posts, CMS already has suspended non-emergency inspections and has issued COVID-19 guidance to hospitals and nursing facilities. Arent Fox’s Health Care group will continue to track COVID-19 developments and their effect on the health care industry.