On May 19, 2020 the Centers for Medicare and Medicaid (CMS) published the payment rates for the new Covid-19 testing codes.  Please see below.

On March 13, 2020 the American Medical Association (AMA) created CPT code 87635 for infectious agent detection by nucleic acid tests.

On April 10, 2020 the AMA created CPT codes 86769 and 86328 for serology tests.  Laboratories and qualified physician practices performing these tests may bill Medicare for services that occurred after their respective effective dates.

Local Medicare Administrative Contractors (MACs) are responsible for developing the payment amount for claims they receive for these newly created HCPCS codes in their respective jurisdictions until Medicare establishes national payment rates. The payment amounts are identified below.  As with other laboratory tests, there is generally no beneficiary cost sharing under Original Medicare.

Professional Reimbursement Managers

You work hard to earn your fees. At Professional Reimbursement Managers (PRM), we work even harder to collect them. Established in 1995, PRM Billing has a proven track record of increasing and accelerating cash flow for hardworking medical professionals.

No other company matches our commitment to customer service, total transparency, and complete accountability.  PRM Billing takes total responsibility for the financial health of your practice.

Lanny Menendez

Professional Reimbursement Managers