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Transmittal 20-22 Updates to the Laboratory Billing Codes and Reimbursement Rates for COVID-19 Testing


Thursday, May 14, 2020

This transmittal provides notice of coverage and reimbursement for additional HCPCS and CPT codes related to COVID-19 diagnostic testing. It also provides updates to the Department of Health Care Finance (DHCF) billing guidance contained in two previous transmittals: Transmittal # 20-09: Laboratory Billing Codes and Reimbursement Rates for COVID-19 Testing issued on March, 20, 2020 and Transmittal #20-13 Updates to the Laboratory Billing Codes and Reimbursement Rates for COVID-19 Testing issued on April 8, 2020. The Centers for Medicare & Medicaid Services (CMS), has issued two new HCPCS codes (U0003 and U0004) for diagnostic testing which are reimbursable by DHCF for medically necessary, clinically appropriate COVID-19 diagnostic testing effective March 18, 2020.  In addition, DHCF is adding CPT code 86328 and 86769 for novel coronavirus antibody tests effective April 10, 2020.