CMS releases payment rates for COVID-19 test CPT codes

CMS updated its COVID-19 test pricing to include Medicare payment rates for three Current Procedural Terminology (CPT®) codes, according to guidance released May 19.

Medicare will pay at the following rates for CPT codes:

• 86328 (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) will be paid at $45.23
• 86769 (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) will be paid at $42.13
• 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) will be paid at $51.31

According to the American Medical Association, CPT code 87635 should be used for diagnostic testing, while CPT codes 86769 and 86328 are most appropriate to use for antibody testing.