HCPCS Level II Codes for SARS-CoV-2/COVID-19 Testing
Two HCPCS Level II codes for COVID-19 testing have an implementation date of April 1, 2020, which is when Medicare claims processing systems will be able to accept the codes. Dates of service can go back to Feb. 4, 2020. Private payers may accept these codes, as well, so healthcare organizations that report these tests should confirm payer preference.
According to the April 2020 file on the Centers for Medicare & Medicaid Services (CMS) HCPCS Quarterly Update page, these are the descriptors for the new codes:
U0001 CDC 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel
U0002 2019-ncov coronavirus, sars-cov-2/2019-ncov (covid-19), any technique, multiple types or subtypes (includes all targets), non-CDC
Code U0001 is appropriate for the use of tests developed by the CDC. Code U0002 will allow labs to bill for non-CDC tests.
CMS has released a document with test pricing for U0001 and U0002. For U0001 (CDC tests), the test prices listed are $35.91 or $35.92, depending on the Medicare Administrative Contractor (MAC) jurisdiction. The U0002 test prices listed are $51.31 or $51.33.