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Healthcare-Associated
Infections

Enteric
Infections

Women's Health & Sexually-Transmitted Infections

COVID-19

Point of Care
CodeMap®-BD MAX™ System Reimbursement Information

Please select your state:

Fees Reflect 2022 CMS Medicare Fee Schedules

Medicare FFS Claims: 2% Payment Adjustment (Sequestration) Changes

No payment adjustment through March 31, 2022
1% payment adjustment April 1 - June 30, 2022
2% payment adjustment beginning July 1, 2022
Source


BioGX or BD SARS-CoV-2 Reagents for BD MAX™ System
CPT® Code Description
Medicare Coverage
NATIONAL LIMIT
Medicare Reimbursement
NATIONAL LIMIT
Medicaid Reimbursement
  87635 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique
  CCI   MUE  
$ 51.31
N/A
  U0003* Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, making use of high throughput technologies as described by cms-2020-01-r
  CCI   MUE  
$ 75.00
N/A
  U0005** Infectious agent detection by nucleic acid (dna or rna); severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), amplified probe technique, cdc or non-cdc, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either hcpcs code u0003 or u0004) as described by cms-2020-01-r2
  MUE  
$ 25.00
N/A


*A high throughput technology uses a platform that employs automated processing of more than two hundred specimens a day. https://www.cms.gov/files/document/cms-2020-01-r.pdf

**For more information on use of U0003, U0004, and U0005 please see: CMS COVID-19 FAQ on Billing
and CMS-2020-1-R2



BD SARS-CoV-2/Flu for BD MAX™ System
CPT® Code Description
Medicare Coverage
NATIONAL LIMIT
Medicare Reimbursement
NATIONAL LIMIT
Medicaid Reimbursement
  87636 Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A and B, multiplex amplified probe technique
  CCI   MUE  
$142.63
N/A


BD Veritor™ System for the Rapid Detection of SARS-CoV-2
CPT® Code Description
Medicare Coverage
NATIONAL LIMIT
Medicare Reimbursement
NATIONAL LIMIT
Medicaid Reimbursement
  87426 Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19])
  MUE  
TBD
N/A
  87426-QW
CLIA Waived
Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19])
  MUE  
TBD
N/A


BD Veritor™ System for Rapid Detection of SARS-CoV-2 & Flu A+B
CPT® Code Description
Medicare Coverage
NATIONAL LIMIT
Medicare Reimbursement
NATIONAL LIMIT
Medicaid Reimbursement
  87428 Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19]) and influenza virus types A and B
  CCI   MUE  
$ 30.94
N/A
  87428-QW
CLIA Waived
Infectious agent antigen detection by immunoassay technique, (eg, enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], fluorescence immunoassay [FIA], immunochemiluminometric assay [IMCA]) qualitative or semiquantitative; severe acute respiratory syndrome coronavirus (eg, SARS-CoV, SARS-CoV-2 [COVID-19]) and influenza virus types A and B
  CCI   MUE  
$ 30.94
N/A

Specimen Collection
CPT® Code Description
Medicare Coverage
NATIONAL LIMIT
Medicare Reimbursement
NATIONAL LIMIT
Medicaid Reimbursement
  G2023 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]), any specimen source
  MUE  
$ 23.46
N/A
  G2024 Specimen collection for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (coronavirus disease [covid-19]) from an individual in a snf or by a laboratory on behalf of a hha, any specimen source
  MUE  
$ 25.46
N/A

COVID-19 Frequently Asked Questions (FAQs) on Medicare Fee-for-Service (FFS) Billing







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The information contained in this website has been compiled by CodeMap, L.L.C. to assist Becton, Dickinson and Company customers. CodeMap, L.L.C. remains solely responsible for its content. The information provided is for general educational purposes only and may not be conclusive or exhaustive. Recent changes in applicable law, regulations and interpretations may not be reflected in the information contained herein. For technical questions, please contact CodeMap at (847) 381-5465.

CodeMap® has made every reasonable effort to ensure the accuracy of the information contained on this website. However, the ultimate responsibility for correct coding and claims submission lies with the provider of services. CodeMap® makes no representation, warranty, or guarantee that this compilation of Medicare information is error-free or that the use of this information will result in Medicare coverage and subsequent payment of claims. Final coverage and payment of claims are subject to many factors exclusively controlled by CMS and its contractors.

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06/26/2022 04:18:33 3.235.78.122