Coding Guidance for Pharmacies
New York Medicaid plans will reimburse Providers for COVID-19 specimen collection or CLIA waived COVID-19 testing for Medicaid Members, when such collection or testing is in compliance with the Governor’s Executive Order #202.24.
To see the full announcement please click here.
Effective 07/01/2020-
Medicare and Commercial:
Effective for DOS 03/01/2020 and thereafter
These codes should only be used when the provider or facility is NOT running the test.
+Providers should bill 99211-CS for collecting specimen in the office setting.
+Independent clinical diagnostic laboratories should bill G2023 or G2024 (for patients that are homebound, in skilled nursing facility)
+Outpatient Hospitals should use C9803 to code for symptoms assessment and specimen collection.
Medicaid:
Effective for DOS 05/01/2020 and thereafter (consistent with NY Medicaid billing guidance)
+Practicioners and Clinics should bill G2023 or G2024 -this code should be bill ONLY when NO OTHER service was given to the patient on that particular DOS AND the provider is NOT billing for Laboratory COVID-19.
+ Independent Laboratories (POS 81) are NOT reimbursed separately for specimen collection
Code Definitions:
G2023 – Specimen collecton for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) by a laboratory on behalf of a home health agency, any specimen source
G2024 – Specimen collecton for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) from an individual in a skilled nursing facility by a laboratory, any specimen source
C9803 – Hospital outpatent clinic visit specimen collecton for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), any specimen source
99211-CS – Use for specimen collecton in the physician ofce for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]), any specimen source
KR2 Medical Billing 