- Question: What changes did CMS announce regarding specimen collection fees for COVID-
Answer: As part of the Public Health Emergency (PHE) for the COVID-19 pandemic and in an
effort to be as expansive as possible within the current authorities to have diagnostic
testing available to Medicare beneficiaries who need it, in the interim final rule with
comment period, CMS is changing the Medicare payment rules during the PHE for the
COVID-19 pandemic to provide payment to independent laboratories for specimen
collection from beneficiaries who are homebound or inpatients not in a hospital for COVID-
19 testing under certain circumstances.
- Question: Who can bill for the Medicare specimen collection fee?
Answer: Independent laboratories can bill Medicare through their MAC for the specimen
collection fee. The specimen collection fee applies if the specimen is collected by trained
laboratory personnel from a homebound or non-hospital inpatient and the specimen is a
type that would not require only the services of a messenger pick up service. However, the
specimen collection fee is not available for tests where a patient collects his or her own specimen.
- Question: What is the nominal fee for specimen collection for COVID-19 testing for
homebound and non-hospital inpatients during the PHE?
Answer: The nominal specimen collection fee for COVID-19 testing for homebound and
non-hospital inpatients generally is $23.46 and for individuals in a non-covered stay in a SNF
or whose samples are collected by a laboratory on behalf of an HHA is $25.46.