As more labs perform Covid variant testing, will payors reimburse?

August 24, 2021

By: Tami Shaw, Client Manager, and Mick Raich, President of RCM Consulting, Lighthouse Lab Services.

Dr. William Budd of Compass Labs in Nashville, Tenn., wants to help educate his community and his clients and make a difference in this pandemic. Working with their county health department, Dr. Budd’s lab is testing to determine the Covid-19 variants ravaging their community. After the county started testing every positive case for variants, Dr. Budd thought he should offer this service to all of his clients. 

The reasoning behind this is easy, Dr. Budd says.

“This is not the same Covid as last year and there are treatment implications with each variant,” says Budd. “The severity of the strain of Covid can vary. It is medically significant to know if your patient has an aggressive variant vs. a less aggressive variant.

“Determining these variants is significant in showing medical necessity,” Budd continues. “It’s gone beyond knowing the numbers in a particular community. We’re now using this knowledge to drive physician choices and treatment and to help educate the patient to understand the severity of this variant.” 

The real issue here is whether or not the insurance companies will pay for these tests. Medicare has confirmed they will pay for variant testing, but will Medicaid and private insurance companies pay for this crucial service as well? We will know soon, as Compass has recently started billing for this service to all the payors. Stay tuned.

Meanwhile, Dr. Budd and his team will continue to test for variants and continue to try to help the providers and patients in his community.

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