Children's Community Health Plan is closely monitoring COVID-19. As your partners in care, our top priorities are the health and safety of our members and of the providers who deliver care.
We will be providing resources, updates and support to our providers on this page as information becomes available. Be sure to check back often for the latest.
Coding and Reimbursement
We are keeping up-to-date with Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS) and other national and local resources to establish and update coding guidelines and reimbursements.
We want to ensure that providers are using the correct codes when submitting COVID-19 related claims, and are following the appropriate CDC guidance on diagnosis coding for the date of service. The CDC has provided interim coding guidance on which ICD-10 diagnosis codes to report. View the CDC Interim code guidelines.
Other CPT Laboratory Test Codes
The American Medical Association (AMA) has created CPT code 87635 for lab testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Learn more about this code here.
HCPCS Laboratory Testing Codes
CMS has created the following HCPCS codes for laboratory testing. The codes below should be used when billing for COVID-19 testing:
- HCPCS U0001
- This code is used for the laboratory test developed by the CDC
- HCPCS U0002
- This code is used for the laboratory test developed by entities other than the CDC
Both codes are effective Feb, 4, 2020 and will be available for claims processing on April 1, 2020.
Laboratory Testing Reimbursement
CCHP is following the reimbursement rates that were announced by the CMS for COVID-19 testing. Testing must be done at approved locations in accordance with the CDC.
CCHP will not be amending contracts for COVID-19 measures. We will add applicable COVID-19 codes to all appropriate fee schedules.
CCHP has waived all member cost sharing, including copays, coinsurance and deductibles, for COVID-19 diagnostic testing provided in accordance with Centers for Disease Control and Prevention (CDC) guidelines for all Medicaid and Marketplace/Commercial members. CCHP will follow all guidance and protocols issued by the CDC, Centers for Medicaid & Medicaid Services (CMS), state and local public health departments regarding COVID-19.