Attention lab providers: COVID-19 update regarding reimbursement

Reimbursement changes to COVID-19 laboratory services codes for Commercial, and Medicare Advantage and Medicaid 

Beginning with dates of service on or after May 12, 2023, representing the end of the COVID Public Health Emergency (PHE), or if extended, such later date, reimbursement for COVID-19 laboratory services codes will be reduced for laboratory providers contracted as Independent Laboratory (Ancillary) providers and participating in an Anthem Blue Cross (Anthem) independent laboratory provider network.

New COVID-19 laboratory service codes were implemented and reimbursed at rates to meet the needs of laboratory providers during the PHE. This notice is to inform you that reimbursement will be revised to Anthem’s standard reimbursement methodology for Independent laboratory providers for the following codes once the PHE has ended: 

The revised standard fee schedule for the COVID-19 laboratory services codes outlined above to take effect upon the expiration of the PHE, May 11, 2023, can be viewed on Availity.com.

If you have any questions regarding this notice, please contact your designated Ancillary Provider Network Manager. Please incorporate this notice into your Anthem provider agreement folder.