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October 15, 2020 04:44 PM

CMS to pay labs more for quicker COVID-19 testing

Modern Healthcare
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    Modern Healthcare Illustration / Getty Images

    CMS on Thursday launched a new incentive to encourage laboratories to process COVID-19 tests quicker, giving them more money if they can deliver results in two days or less.

    Currently, laboratories are paid $100 per high-throughput COVID-19 test they process. Under the updated guidelines that go into effect Jan. 1, 2021, only laboratories who meet the two day target will receive that payment; labs with slower results will only receive $75 per test.

    "Today's announcement 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 Administrator Seema Verma said in a statement.

    CMS initially paid $51 per high-throughput COVID-19 test, but increased the payments in April.

    Labs receiving the higher payments also have to complete the majority of all their COVID-19 tests with high-throughput technology within two days, regardless of if they're covered by Medicare, according to the agency.

    Medicare reimbursement for COVID-19 tests falls far below commercial insurers' rates. Providers billed insurers $144 on average for COVID diagnostic tests, with the prices ranging from one penny all the way up to $14,750, according to a September study in the Journal of General Internal Medicine, which drew on about 182,000 claims for tests provided by independent laboratories and outpatient hospital settings.

    Hospitals have taken steps to improve their labs' efficiency, ranging from changing protocol and finding ways to collaborate with other staff teams.

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