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.
dhcf
Department of Health Care Finance - DHCF
Public Notice: Due to the MMIS conversion the last provider payment from Conduent was issued on February 27. There will be no payment issued on March 6, and the first post‑conversion payment will be issued on March 13. For more information visit https://medicaid.dc.gov/
