CMS boosts payment, publishes new U-codes for COVID-19 testing using high-throughput tech

April 20, 2020

CMS announced on April 15 that Medicare will nearly double payment for certain lab tests that use high-throughput technologies to rapidly diagnose large numbers of COVID-19 cases.

RELATED: View previously published codes and payment rates related to COVID-19 testing.

Medicare will pay $100 for COVID-19 clinical diagnostic lab tests making use of high-throughput technologies developed by the private sector that allow for increased testing capacity and faster results. According to the press release issued by CMS, “high-throughput lab tests can process more than two hundred specimens a day using highly sophisticated equipment that requires specially trained technicians and more time-intensive processes to assure quality.”

Medicare will pay laboratories for the tests at $100 effective April 14, 2020, through the duration of the COVID-19 national emergency, which is currently slated to expire June 30.

Additionally, the following codes were created to identify these tests:

  • U0003:  Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies as described by CMS-2020-01-R.
  • U0004:  2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19), any technique, multiple types or subtypes (includes all targets), non-CDC, making use of high throughput technologies as described by CMS-2020-01-R.

U0003 should identify tests that would otherwise be identified by CPT code 87635 but are instead performed with these high-throughput technologies.  Conversely, U0004 should identify tests that would otherwise be identified by U0002 but are performed with these high-throughput technologies. Finally, neither U0003 nor U0004 should be used for tests that detect COVID-19 antibodies.

View the full guidelines from CMS:

According to CMS, Examples of high-throughput technology as of April 14, 2020 include, but are not limited to, technologies marketed on that date as the Roche cobas 6800 System, Roche cobas8800 System, Abbott m2000 System, Hologic Panther Fusion System, GeneXpert Infinity System, and NeuMoDx 288 Molecular.

Feel free to reach out to us directly if you are seeking additional clarification on these codes.

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