COVID-19: Allowances for laboratory test codes

CMS has established new codes for laboratory tests for the novel coronavirus (COVID-19). CMS provided pricing for codes U0001 and U0002, but instructed MACs to develop the allowance for the remaining codes. Those codes and allowances are below:

Codes U0003 and U0004 were removed from this list; they were added to the clinical laboratory fee schedule (CLFS) January 1, as was code U0005. The 2021 CLFS is available here.

Code Allowance
U0001  $35.92
U0002  $51.31
0202U $416.78
0223U $416.78
0224U $42.13
0225U $416.78
0226U $42.28
0240U $142.63
0241U $142.63
86408 $42.13
86409 $105.33
86413 $42.13
87426 $42.03
87428 $73.49
87635 $51.31
87636 $142.63
87637 $142.63
87811 $41.38
87913 $257.45

 

Source: https://www.cms.gov/files/document/mac-covid-19-test-pricing.pdf