Apr 15, 2020

CMS Increases Medicare Reimbursement for COVID-19 High-Throughput Lab Tests to Encourage Rapid Testing

By Brian M. Foley, Esq.

The Centers for Medicare & Medicaid Services (CMS) today announced Medicare will nearly double payment for certain lab tests that use high-throughput technologies to rapidly diagnose large numbers of Coronavirus (COVID-19) cases. “CMS has made a critical move to ensure adequate reimbursement for advanced technology that can process a large volume of COVID-19 tests rapidly and accurately,” said CMS Administrator Seema Verma.

Medicare will pay the higher payment of $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, faster results, and more effective means of combating the spread of the virus. 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, approximately double the usual rate of $51, effective April 14, 2020, through the duration of the COVID-19 national emergency. 

This announcement adds to recent CMS actions to expand testing for COVID-19. CMS announced previously that Medicare will pay new specimen collection fees for COVID-19 testing for homebound and non-hospital inpatients, to help facilitate the testing of homebound individuals and those unable to travel. As a result of these actions, laboratories will have expanded capability to test more vulnerable populations, like nursing home patients, quickly and provide results faster. Additionally, CMS took action to allow healthcare systems, hospitals, and communities to set up testing sites to identify COVID-19-positive patients in a safe environment. Rapid and accurate testing is a vital tool to combat the Coronavirus Pandemic. 

If you have any questions or would like guidance on navigating health care regulatory or reimbursement issues, please contact Brian M. Foley, Esq., at bmf@spsk.com or 973-540-7326, or any member of the Health Care Law Practice Group at Schenck, Price, Smith & King, LLC.

DISCLAIMER: This Alert is designed to keep you aware of recent developments in the law. It is not intended to be legal advice, which can only be given after the attorney understands the facts of a particular matter, and the goals of the client.



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