CMS incentivizes labs to complete high throughput COVID-19 tests quicker
The Centers for Medicare and Medicaid Services (CMS) recently announced starting January 1, 2021, Medicare will pay $100 to laboratories that complete high throughput COVID-19 diagnostic tests within two calendar days of the specimen being collected. Also effective January 1, 2021, for laboratories that take longer than two days to complete these tests, Medicare will pay $75.
CMS is trying to ensure that patients who test positive are alerted quickly so they can self-isolate and receive medical treatment. This announcement builds on previous actions CMS has taken to ensure robust laboratory testing for COVID-19. In April, CMS doubled the payment for COVID-19 tests performed using high throughput technology to $100. COVID-19 testing using high throughput technologies allows for increased testing capacity using an automated process that can administer more than 200 tests per day. The new payment amounts effective January 1, 2021 ($100 and $75) reflect the resource costs laboratories face for completing COVID-19 diagnostic tests using high throughput technology in a timely fashion during this Public Health Emergency.
The enormous number of Americans getting swabbed for the coronavirus has overwhelmed every step of the COVID-19 testing process, creating shortages of critical supplies in laboratories and inundating them with more specimens than they can process.
"The challenges that labs are facing are complex," said Louise Serio, a spokesperson for the American Clinical Laboratory Association (ACLA). "There is a significant strain on the global supply chain."
"We’re concerned this policy could create a domino effect where patient access to testing is severely reduced," ACLA President Julie Khani said in a statement. "Cutting laboratory reimbursement won’t address the root causes of delayed turnaround times."
Labs still can't get the chemicals they need to run the tests, or the plastic materials such as pipettes or tubes to transport specimens, said Dr. Patrick Goodbye, president of the College of American Pathologists.
"If we can’t get the reagents, we can’t get the consumables—and we still can’t—then it’s really not good to penalize labs for doing the best job they can," Godbey said. "The pathologists, the labs themselves, don’t control the supply chain. We’re going to be penalized for that."
Quadax understands the enormous pressure labs are facing. Our client service team is supplemented with various dedicated resources to react quickly to client needs. Let us deliver financial management that streamlines medical billing, enhances visibility and control over financial operations, and mitigates compliance risks for maximum reimbursement—while you focus on delivering essential diagnostic health information to patients and providers.
These common FAQs from CMS provide additional information on COVID-19 billing.
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Harley Ross is Executive Vice President and Chief Revenue Officer with executive oversight over the Revenue Cycle Services (RCS) division which supports Quadax’s full service revenue cycle platform. Part of his role is to lead and support go to market strategies for both existing and new products for RCS in support of new and existing clients. In his time with Quadax, he has a varied background spanning sales and client services leadership and has worked closely with product and operations to help grow the RCS division. Leveraging his experience and knowledge of software and technology that spans over 20 years, he is a passionate executive leader with a focus on delivering solutions to a variety of market segments which spans the spectrum of finance, revenue cycle, managed care, commercial sales and information technology with a specific focus on the laboratory, medical device, diagnostic and durable medical equipment (DME) segments.