COVID-19 MAC Test Pricing

Today, the Centers for Medicare & Medicaid Services (CMS) is posting a fact sheet to the CMS.gov website to aid Medicare providers with information relating to the pricing of both the CDC and non CDC tests.  You can find the fact sheet here:  https://www.cms.gov/files/document/mac-covid-19-test-pricing.pdf

Additionally, CMS will be tweeting about this new information.  Tweets can be found below. We encourage relevant stakeholders to retweet.

• Medicare will be covering  #COVID19 tests, and there is generally no copay for original #Medicare - deductible applies. @CMSGov is also permitting #MedicareAdvantage plans to waive cost sharing for these tests.

• Medicare’s initial payment for the @CDCgov test will be about $36 & non-CDC tests will be around $51. These prices may vary slightly depending on the local Medicare Administrative Contractor (MAC). View the full price by MAC list here:  https://www.cms.gov/files/document/mac-covid-19-test-pricing.pdf

Earlier CMS actions in response to the COVID-19 virus, are part of the ongoing White House Task Force efforts. To keep up with the important work CMS is doing in response to COVID-19, please visit the Current Emergencies Website.

Centers for Medicare & Medicaid Services (CMS) has sent this Center for Medicare and Medicaid Innovation (CMMI) Update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.