New COVID-19 Specimen Collection Rate

May 21, 2020

In response to the coronavirus disease 2019 (COVID-19), the Centers for Medicare & Medicaid Services (CMS) established HCPCS code C9803 for specimen collection in a hospital outpatient clinic setting, among other codes. Accordingly, the Department of Health Care Services (DHCS) is establishing a reimbursement rate for the new code. The rate is based on the most recent corresponding Medicare rate, and is reimbursed at 100 percent of the Medicare rate. It is exempt from the ten percent payment reductions in Welfare and Institutions Code (W&I Code) Section 14105.192.

Upon expiration of the public health emergency or national emergency, this rate will be amended to correspond with the clinical laboratory services methodology in W&I Code Section 14105.22, including the application of the Assembly Bill 97 (AB 97) payment reduction.

The updated manual pages reflecting this change will be released in a future Medi-Cal Update..