Rates for Certain COVID-19 Diagnostic Testing HCPCS Codes Updated
March 1, 2021
Effective for dates of service on or after January 1, 2021, the base payment amount for HCPCS Codes U0003 (Infectious agent detection by nucleic acid [DNA or RNA]; Severe Acute Respiratory Syndrome Coronavirus 2 [SARS-CoV-2] [Coronavirus disease (COVID-19)], amplified probe technique, making use of high throughput technologies as described by CMS-2020-01-R), and U0004 (2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV [COVID-19], any technique, multiple types or subtypes [includes all targets], non-CDC, making use of high throughput technologies as described by CMS-2020-01-R), has been adjusted from $100 to $75.
||SARS Cov-2 COVID-19 Amp prob high throughput
||COVID-19 lab test non-CDC high throughput
Additionally, the codes listed above will be exempt from the 10 percent payment reductions in Welfare and Institutions Code (W&I Code) section 14105.192, as described at Attachment 4.19-B, page 3.3, paragraph 13 of the State Plan.
An Erroneous Payment Correction (EPC) will be issued for affected claims for codes U0003 and U0004 retroactive to dates of service on or after January 1, 2021.