Medicare Administrative Contractor Payments for Antibody Tests

CMS has posted[1] the amounts that every MAC is paying for COVID-19 lab tests, including antibody tests. Some hospitals have been holding claims for the two antibody tests because it was unclear until recently what the payment would be.[2]

MAC

Jurisdiction

MAC States/Territories

U0001 Test Price

U0002 Test Price

87635 Test Price

86769 Test Price

86328 Test Price

J6 – NGS

Illinois, Minnesota, Wisconsin

$35.91

$51.31

$51.31

$42.13

$45.23

JK – NGS

Connecticut, New York, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont

$35.91

$51.31

$51.31

$42.13

$45.23

JH – Novitas

Arkansas, Colorado, New Mexico, Oklahoma, Texas, Louisiana, Mississippi

$35.92

$51.31

$51.31

$42.13

$45.23

JL – Novitas

Delaware, District of Columbia, Maryland, New Jersey, Pennsylvania; Part B services include Arlington and Fairfax counties in Virginia, and the city of Alexandria, Virginia

$35.92

$51.31

$51.31

$42.13

$45.23

JN – FCSO

Florida, Puerto Rico, U.S. Virgin Islands

$35.92

$51.31

$51.31

$42.13

$45.23

JJ – Palmetto

Alabama, Georgia, Tennessee

$35.91

$51.31

$51.31

$42.13

$45.23

JM – Palmetto

North Carolina, South Carolina, Virginia, West Virginia

$35.91

$51.31

$51.31

$42.13

$45.23

JE – Noridian

California, Hawaii, Nevada, American Samoa, Guam, the Northern Mariana Islands

$35.91

$51.31

$51.31

$42.13

$45.23

JF – Noridian

Alaska, Arizona, Idaho, Montana, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming

$35.91

$51.31

$51.31

$42.13

$45.23

J5 – WPS

Iowa, Kansas, Missouri, Nebraska

$35.92

$51.31

$51.31

$42.13

$45.23

J8 – WPS

Indiana, Michigan

$35.92

$51.31

$51.31

$42.13

$45.23

J15 – CGS

Kentucky, Ohio

$35.92

$51.31

$51.31

$42.13

$45.23

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