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COVID-19: Allowances for laboratory test codes
Last Modified: 1/12/2021
Location: FL, PR, USVI
Business: Part A, Part B
The Centers for Medicare & Medicaid Services (CMS) has established new codes for laboratory tests for the novel coronavirus (COVID-19). CMS provided pricing for codes U0001 and U0002, but instructed Medicare administrative contractors (MACs) to develop the allowance for the remaining codes. Those codes and allowances are below:
Codes U0003 and U0004 were removed from this list; they were added to the clinical laboratory fee schedule (CLFS) January 1, as was code U0005. The
2021 CLFS is available
here 
.
Code |
Allowance |
U0001 |
$35.92 |
U0002 |
$51.31 |
0202U |
$416.78 |
0223U |
$416.78 |
0224U |
$42.13 |
0225U |
$416.78 |
0226U |
$42.28 |
0240U |
$142.63 |
0241U |
$142.63 |
86408 |
$42.13 |
86409 |
$105.33 |
86413 |
$42.13 |
87426 |
$45.23 |
87428 |
$73.49 |
87635 |
$51.31 |
87636 |
$142.63 |
87637 |
$142.63 |
87811 |
$41.38 |
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.