Date
The MO HealthNet Division (MHD) is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus. The virus has been named "SARS-CoV-2" and the disease it causes has been named "coronavirus disease 2019" (abbreviated "COVID-19").
MO HealthNet continues to monitor The Centers for Medicare and Medicaid Services (CMS) guidance related COVID-19 testing and specimen collection. The tables below list the COVID-19 testing and specimen collection procedure codes MO HealthNet currently covers as well as who can bill each code, effective dates, max units, and rates.
| COVID-19 Testing Codes | |||||
| Code | Description | Who can bill this code? | Effective with dates of service on or after: |
Max Units | Rate |
| U0001 | CDC 2019 novel coronavirus (2019-ncov) real-time rt-pcr diagnostic panel | Providers with the appropriate CLIA Certificate type for the test | 2/1/2020 | 1 | $36.00 |
| U0002 | 2019-nCoV Coronavirus, SARS-CoV-2/2019-nCoV (COVID-19) using any technique, multiple types or subtypes (includes all targets) | Providers with the appropriate CLIA Certificate type for the test | 2/1/2020 | 1 | $51.00 |
| 87635 | 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 | Providers with the appropriate CLIA Certificate type for the test | 3/13/2020 | 1 | $51.00 |
| 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. | Providers with the appropriate CLIA Certificate type for the test | 3/18/2020 | 1 | $100.00 |
| 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. | Providers with the appropriate CLIA Certificate type for the test | 3/18/2020 | 1 | $100.00 |
| 86328 | Immunoassay for infectious agent antibody(ies), qualitative or semiquantitative, single step method (e.g., reagent strip); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]). | Providers with the appropriate CLIA Certificate type for the test | 4/10/2020 | 1 | $45.23 |
| 86769 | Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]). | Providers with the appropriate CLIA Certificate type for the test | 4/10/2020 | 1 | $42.13 |
| COVID-19 Specimen Collection Codes | |||||
| Code | Description | Who can bill this code? | Effective with dates of service on or after: |
Max Units | Rate |
| 99211 | Medicare suggests using the Level 1 evaluation and management code for assessment and specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | Physician office | 3/1/2020 | 1 | $15.31 |
| C9803 | Hospital outpatient clinic visit specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | Hospital outpatient department | 3/1/2020 | 1 | Percent of billed charges |
| G2023 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source | Independent Laboratories | 3/1/2020 | 1 | $23.46 |
| G2024 | Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), from an individual in a skilled nursing facility or by a laboratory on behalf of a home health agency, any specimen source | Independent Laboratories | 3/1/2020 | 1 | $25.46 |