Starting January 1, 2021, Medicare will pay $100 only to laboratories completing high throughput COVID-19 diagnostic tests within two calendar days of the specimen being collected. Also effective January 1, 2021, for laboratories taking longer than two days to complete these tests, Medicare will pay a rate of $75. CMS is working to ensure patients who test positive for the virus are alerted quickly so they can self-isolate and receive medical treatment.

  • Medicare will lower the base payment amount for COVID tests run on high-throughput technology to $75 (this impacts codes U0003 and U0004)
  • Medicare will make an additional $25 add-on payment to labs who complete these tests in two calendar days
  • To qualify for the add-on payment labs need to have performed 51% or more of all COVID high throughput tests in 2 days for the previous month
  • The add-on code of U0005 will need to be billed with either the U0003 or U0004.

For more information, review the CMS Ruling (CMS-2020-1-R2)

For more information, please contact Marketing, 402-489-1207.


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