New CMS guidelines outline compensation rates for SARS-CoV-2 serology tests for clinical laboratories and pathology groups.
The Centers for Medicare and Medicaid Services (CMS) released reimbursement rates for SARS-CoV-2 serology testing on May 19, 2020. CMS announced at the end of April that it would cover SARS-CoV-2 serology testing costs but had not set reimbursement rates.
The American Medical Association (AMA) created two Current Procedural Terminology (CPT) codes on April 10, 2020, for SARS-CoV-2 serology testing. Code 86769 is for SARS-CoV-2 serology tests that use multiple-step methods, while code 86328 is used for serology testing with a single-step method immunoassay.
Details of the announcement by Medicare administrative contractor (MAC) jurisdiction can be found through the May 19, 2020, release that is detailed at this link for the two codes below and more:
- $42.13 for code 86769
- $45.23 for code 86328
American Clinical Laboratory Association President Julie Khani released a statement following the CMS announcement, explaining that these rates “will encourage a broad cross section of laboratories to rapidly scale up capacity for accurate and reliable serologic testing for SARS-CoV-2.”
Medicare Administrative Contractor (MAC) COVID-19 Test Pricing May 19, 2020
ACLA Statement on Medicare Reimbursement Rate For Serologic Testing