For dates of service or admittance on or after February 4, 2020, providers will be eligible to seek reimbursement for COVID-19 testing and testing-related visits for uninsured individuals, as well as treatment for uninsured individuals with a COVID-19 diagnosis. All claims will be subject to the same timely filing requirements required by Medicare and available funding.
Reimbursement under this program will be made for qualifying testing for COVID-19 and treatment services with a primary COVID-19 diagnosis, as determined by HRSA (subject to adjustment as may be necessary), which include the following:
Specimen collection, diagnostic and antibody testing.
Testing-related visits including in the following settings: office, urgent care or emergency room or telehealth.
Treatment: office visit (including telehealth), emergency room, inpatient, outpatient/observation, skilled nursing facility, long-term acute care (LTAC), acute inpatient rehab, home health, DME (e.g., oxygen, ventilator), emergency ambulance transportation, non-emergent patient transfers via ambulance, and FDA approved drugs as they become available for COVID-19 treatment and administered as part of an inpatient stay.
When an FDA-approved vaccine becomes available, it will also be covered.
View billing codes for more info.
Services not covered by traditional Medicare will also not be covered under this program. In addition, the following services are excluded:
Any treatment without a COVID-19 primary diagnosis, except for pregnancy when the COVID-19 code may be listed as secondary.
Outpatient prescription drugs.
All claims submitted must be complete and final. Interim bills, corrected claims, late charges, voided claim transactions and appeals will not be accepted.