I gleamed info from newly released CPT Coding Assistant October 2020 edition: AMA Panel expedited the publication of additional codes to the AMA website on October 6, 2020, at https://www.ama-assn.org/practice-management/cpt/covid-19-coding-and-guidance. These codes are effective immediately for use in reporting these laboratory tests.
So, rather than utilizing existing code of 87631, new code of 87636 would be used for severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) (Coronavirus disease [COVID-19]) and influenza virus types A and B, multiplex amplified probe technique.
Questions:
- CMS Medicare has not released reimbursement rate yet for 87636?
- Insurance Payers likely to wait on CMS Medicare rate to add to their fee schedules for reimbursement to physician offices for the testing with immediate results in office?
- Most insurance payers, when CMS rate is not attached to new codes, will default to a percentage based on payer contract with provider for reimbursement?