2022 Laboratory Fee Schedule

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




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COVID-19
Visby Medical COVID-19 Point of Care Test-Emergency Use Authorization
CPT Code
CPT Code Description
Medicare Coverage
National
Medicare
Reimbursement
National
Medicaid
Reimbursement
87635-QW*
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

*QW should only be used when running this test in a CLIA Waived setting.



STI CT/NG/TV (If all tests are ordered and performed)
CPT Code
CPT Code Description
Medicare Coverage
National
Medicare
Reimbursement
National
Medicaid
Reimbursement
87801-QW*
Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; amplified probe(s) technique
  CCI   MUE  
$ 70.20
N/A

*QW should only be used when running this test in a CLIA Waived setting.




STI CT/NG/TV (If a single test is ordered and performed)
CPT Code
CPT Code Description
Medicare Coverage
National
Medicare
Reimbursement
National
Medicaid
Reimbursement
87491-QW*
Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, amplified probe technique
  CCI   MUE   NCD
$ 35.09
N/A
87591-QW*
Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, amplified probe technique
  CCI   MUE   NCD
$ 35.09
N/A
87661-QW*
Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, amplified probe technique
  CCI   MUE  
$ 35.09
N/A

*QW should only be used when running this test in a CLIA Waived setting.



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