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March 16, 2020

COVID-19: Test Pricing, Diagnostic Lab Tests, Pricing & Codes, and EHB Coverage

COVID-19: Test Pricing; Diagnostic Lab Tests, Pricing & Codes; and EHB Coverage

On March 12, CMS posted a fact sheetExternal PDF with information relating to the pricing of both the Centers for Disease Control and Prevention (CDC) and non-CDC tests.

Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment MLN Matters® Article

A new MLN Matters Article MM 11681 on Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge PaymentExternal PDF is available. Learn about Advanced Diagnostic Laboratory Tests, pricing, and new codes. On page 3, we reference new COVID-19 codes.

Essential Health Benefits (EHB) Coverage

On March 12, CMS issued Frequently Asked QuestionsExternal PDF (FAQs) about EHBExternal Website to ensure individuals, issuers, and states have clear information on coverage benefits for COVID-19. This action is part of the broader, ongoing effort by the White House Coronavirus Task Force to ensure that all Americans – particularly those at high-risk of complications from the COVID-19 virus – have access to the health benefits that can help keep them healthy while helping to contain the spread of this disease.

These FAQs, and earlier CMS actions in response to the COVID-19 virus, are part of the ongoing White House Task Force efforts. To keep up with the important work the Task Force is doing in response to COVID-19; visit the CDC's Coronavirus Disease 2019External Website webpage.

For information specific to CMS, please visit the Current EmergenciesExternal Website website.

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