Wednesday, May 20, 2020

Very Very Brief Blog: CMS Prices COVID Serology Tests at About $45

On May 14, I wrote a blog about the different ways that CMS could potentially price new serology tests for COVID - here.

I'm leaving the original blog from May 14 intact, but on May 19, CMS released pricing for the single-strip and the liquid phase COVID SEROLOGY tests (86328, 86769).  The are priced at $45.23 and $42.13 respectively.
  • See a trade journal article at MedTechDive here.  
  • See ACLA favorable press release here.
  • See Medicare's two-page, May 19, 2020 document online here  CMS published uniform, but contractor (MAC)-established prices for both COVID PCR codes and COVID Serology codes.

Note that the MAC-set prices for U0001 and U0002 (non-high-throughput COVID diagnosis) and the newly announced prices for 86328, 86769 serology - are technically, temporary local MAC prices.  These codes are ALSO going to be discussed for price-setting at the summer Clin Lab Fee Schedule pricing meetings.  This will result in nationally-endorsed pricing on 1/1/2021 for these four codes.   Details here.


A lot has been written over the pro's and con's of serology tests, focusing on either (1) absolute acurracy of tests, and (2) value of tests - what does a positive result mean.  For a pro-serology Op Ed in WSJ, see the May 19 article by Manish Butte and Andrew Bogan; Butte is chief of pediatric immunology at UCLA.


ACLA has a white paper on testing in the battle against COVID, here.