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Analysis

CMS Doubles Medicare Payment for 'High-Throughput' Coronavirus Tests

By John Commins  
   April 15, 2020

Medicare's reimbursement for automated tests will increase from $51 to $100.

In an attempt to reduce lag times for COVID-19 diagnoses and get a better sense of the scope of the pandemic, Medicare said it will nearly double its payments for high-throughput commercial lab tests.

"CMS has made a critical move to ensure adequate reimbursement for advanced technology that can process a large volume of COVID-19 tests rapidly and accurately," CMS Administrator Seema Verma said. "This is an absolute game-changer for nursing homes, where risk of Coronavirus infection is high among our most vulnerable."

The higher $100 payment – an increase from $51 – will be paid to private sector labs, such as Roche, Hologic, Abbott and Cepheid, that have developed highly automated processes to increase testing capacity and achieve faster and more accurate results.

The high-throughput labs can process more than 200 tests each day.

The higher reimbursement rate took effect on Monday and will remain in effect through the duration of the pandemic, CMS said.

A lack of testing kits and long delays in getting the results of COVID-19 tests were citied as a major reason for backups in hospital patient throughput in March, according to a study released this month by the Office of the Inspector General for the Department of Health and Human Services.

The scarcity of the tests, and the subsequent wait for results for patients and staff, which often took a week or longer, had a snowball effect on patient throughput, OIG said in its report. 

“CMS has made a critical move to ensure adequate reimbursement for advanced technology that can process a large volume of COVID-19 tests rapidly and accurately.”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

The higher $100 payment will be given to private sector labs that have developed highly automated processes to increase testing capacity and achieve faster and more accurate results.

The high-throughput labs can process more than 200 COVID-19 tests each day.

A lack of testing kits and long delays in getting the results of COVID-19 tests were citied as a major reason for backups in hospital throughput.


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