The Department of Health and Human Services (HHS) has announced that the federal Public Health Emergency (PHE) for COVID-19, declared under Section 319 of the Public Health Service (PHS) Act, expires at the end of the day on May 11, 2023.
This policy change will impact how commercial insurance plans and government health programs are required to cover the cost of COVID-19-related testing. Accordingly, Labcorp would like to make you and your patients aware of the changes relative to the costs of our COVID-19 testing.
COVID-19 Public Health Emergency Expiration FAQs
Insurance coverage for COVID-19 testing will be affected in the following ways:
Medicare beneficiaries who are enrolled in Part B will continue to have coverage without cost sharing for laboratory-conducted COVID-19 tests when ordered by a provider.
The requirement for Medicare Advantage and private insurance companies to cover COVID-19 tests without cost sharing, both for OTC and laboratory tests, will end. Additionally, some insurers might begin to limit the number of covered tests an individual can take over a certain time period, or require tests to be done by in-network providers. Therefore, based on their benefit plan, members may be responsible for paying for the full price of the test (if non-covered), or for a copay or deductible. Some patients may have no patient responsibility if their plans elect to continue coverage without cost sharing.
State Medicaid programs must provide coverage without cost sharing for COVID-19 testing until the last day of the first calendar quarter that begins one year after the last day of the COVID-19 PHE. That means with the COVID-19 PHE ending on May 11, 2023, this mandatory coverage will end on September 30, 2024, after which coverage may vary by state. Temporary Medicaid coverage options for uninsured patients that provided free COVID-19 testing will end.
Labcorp is committed to supporting you and your patients with a complete portfolio of COVID-19 tests, including respiratory combination tests. The coverage policy changes noted above will affect the following tests:
2019 Novel Coronavirus (COVID-19), NAA 
2019 Novel Coronavirus (COVID-19) With Influenza A, Influenza B and Respiratory Syncytial Virus, NAA 
2019 Novel Coronavirus (COVID-19) With Influenza A and Influenza B, NAA 
2019 Novel Coronavirus (COVID-19) With Respiratory Syncytial Virus, NAA 
SARS-CoV-2 Semi-Quantitative Total Antibody, Spike 
Labcorp will file claims for insured patients directly to Medicare, Medicaid and many insurance companies and managed care plans. However, based on their benefit plan, members may be responsible for paying for the full price of the test (if non-covered), or for a copay or deductible.
Many insurance companies are requiring patients to be symptomatic in order for testing to be covered. Therefore, including relevant ICD-10 codes associated with symptoms may better inform coverage decisions.
There will be no impact on tests ordered prior to or on May 11, 2023. If testing is ordered after May 11, 2023, and the patient is relying on insurance or a government program benefit to pay for COVID-19 testing, then the patient may be responsible for payment for the complete cost of the test, a copay, or a deductible, in accordance with new payor coverage policies.
The turnaround time will remain 1-3 business days.
The U0003 and U0005 codes will no longer be used in billing at the expiration of the PHE (close of business on May 11). Labcorp will return to using the CPT code 87635 when billing the PCR COVID test to insurance.
Antibody testing is available at all Labcorp PSCs. Collection for an active infection (Nasal Swab) is not available at any location. Collection for travel for asymptomatic individuals can be self-initiated through Labcorp’s OnDemand platform (www.ondemand. labcorp.com/covid-19) and collected at selected PSCs if the individual completes an attestation of not being exposed or having symptoms.
COVID-19 Information and Resources
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Find answers to the most common Provider and Payer questions about COVID-19 testing.