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CMS Increases Payment Rates for High-Throughput SARS-CoV-2 Tests

NEW YORK – The Centers for Medicare and Medicaid Services announced Wednesday it is increasing payments for high-throughput SARS-CoV-2 lab tests. 

CMS will pay $100 for SARS-CoV-2 diagnostic tests that use high-throughput technologies allowing for increased capacity and faster results. Labs can bill for these tests using code U0003 for PCR-based coronavirus tests and code U0004 for tests using any technique with high-throughput technology. 

High-throughput tests can process at least 200 specimens per day using "highly sophisticated equipment that requires specially trained technicians and more time-intensive processes to assure quality," the agency said. Examples of high-throughput technology listed by CMS include Roche's Cobas 6800 and 8800 systems, Abbott's m2000 system, Hologic's Panther Fusion system, Cepheid's GeneXpert Infinity system, Thermo Fisher Scientific's Applied Biosystems 7500 Fast Dx Real-Time PCR instrument, and NeuMoDx's 288 Molecular system. 

The original rate set in March was $35.91 or $35.92 for labs using the test developed by the US Centers for Disease Control and Prevention, and between $51.31 and $51.33 for non-CDC tests. For tests that don't use high-throughput technology, Medicare Administrative Contractors remain in charge of the payment rate and are currently paying about $51. 

The new rate took effect on April 14.

"We know that the lack of predictable reimbursement for tests performed has been a barrier to entry for some laboratories, and today’s decision will help encourage all laboratories with the appropriate expertise to come to the table and perform COVID-19 testing." American Clinical Laboratory Association President Julie Khani said in a statement about the rate change. "We also hope that other payers will follow CMS’s strong example of leadership today."

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