The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19").
The MHD continues to monitor Centers for Medicare and Medicaid Services (CMS) guidance related to COVID-19 testing and specimen collection. The table below lists the COVID-19 testing and specimen collection procedure codes the MHD currently covers as well as who can bill each code, effective dates, max units, and rates.
|
COVID-19 Testing Codes |
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|---|---|---|---|---|---|
|
Code |
Description |
Who can bill this code? |
Effective with dates of service on or after: |
Max Units |
Rate |
|
U0001 |
CDC 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel |
Providers with the appropriate CLIA Certificate type for the test |
2/01/2020 |
2 |
$36.00 |
|
U0002 |
2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19) using any technique, multiple types or subtypes (includes all targets) |
Providers with the appropriate CLIA Certificate type for the test |
2/01/2020 |
2 |
$51.00 |
|
87635 |
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 |
Providers with the appropriate CLIA Certificate type for the test |
3/13/2020 |
2 |
$51.00 |
|
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. |
Providers with the appropriate CLIA Certificate type for the test |
3/18/2020 |
2 |
$100.00 |
|
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. |
Providers with the appropriate CLIA Certificate type for the test |
3/18/2020 |
2 |
$100.00 |
|
86328 |
Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single step method (e.g., reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]). |
Providers with the appropriate CLIA Certificate type for the test |
4/10/2020 |
3 |
$45.23 |
|
86769 |
Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]). |
Providers with the appropriate CLIA Certificate type for the test |
4/10/2020 |
3 |
$42.13 |
|
87426 |
Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19]). |
Providers with the appropriate CLIA Certificate type for the test |
06/25/20 |
3 |
$45.23 |
|
COVID-19 Specimen Collection Codes |
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|---|---|---|---|---|---|
|
Code |
Description |
Who can bill this code? |
Effective with dates of service on or after: |
Max Units |
Rate |
|
99211 |
Medicare suggests using the Level 1 evaluation and management code for assessment and specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
Physician office |
03/01/2020 |
1 |
$15.31 |
|
C9803 |
Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
Hospital outpatient department |
3/01/2020 |
1 |
Percent of billed charges |
|
G2023 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source |
Independent Laboratories |
3/01/2020 |
1 |
$23.46 |
|
G2024 |
Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), from an individual in a skilled nursing facility or by a laboratory on behalf of a home health agency, any specimen source |
Independent Laboratories |
3/01/2020 |
1 |
$25.46 |