Laboratories that process coronavirus diagnostic tests within two calendar days will receive a higher Medicare reimbursement than those that take longer, the Centers for Medicare & Medicaid Services announced Thursday.
Medicare will pay $100 to labs that complete the tests during the two-day time frame starting on Jan. 1, 2021. The goal remains to ensure patients who test positive for the disease are alerted quicker so they can self-isolate and access treatment. On the flip side, the program will pay $75 for slower labs.
In mid-April the agency announced that it was doubling the pay rate to $100 per test to labs using high throughput technology, meaning that, in essence, Thursday’s announcement reveals a $25 penalty to those labs that don’t produce results within two days. The agency explained the new payment amounts ($100 and $75) reflect the resource costs laboratories face for completing COVID-19 diagnostic tests using high throughput technology.
“As America continues to grapple with the COVID-19 pandemic, prompt testing turnaround times are more important than ever,” CMS Administrator Seema Verma said.
She added that Thursday’s move “supports faster high throughput testing, which will allow patients and physicians to act quickly and decisively with respect to treatment decisions, physical isolation, and contact tracing.”
CMS explained that the base rate will be lowered to $75 starting in January and labs that meet select requirements can then earn a $25 add-on payment.
“Medicare will make an additional $25 add-on payment to laboratories for a COVID-19 diagnostic test run on high throughput technology if the laboratory: a) completes the test in two calendar days or less, and b) completes the majority of their COVID-19 diagnostic tests that use high throughput technology in two calendar days or less for all of their patients (not just their Medicare patients) in the previous month,” CMS stated.
More information on Thursday’s announcement can be found here.