COVID-19 Add-on CPT Code U0005 Focus of OIG Audits

The Office of Inspector General (OIG) has announced it will begin auditing add-on payments for high-throughput COVID-19 testing reimbursed by Medicare.    

 In January 2021, to support faster COVID-19 testing, CMS lowered reimbursement for COVID-19 laboratory tests using high-throughput technology to $75 and established a new add-on CPT code U0005 and payment of $25 based on turn-around time.  

The new add-on CPT code U0005 can be applied to a covid high-throughput test when the following conditions are met:

1. The test is completed within two calendar days
2. The majority of all COVID high-throughput tests, not just Medicare, in the previous month were completed in two days

During the audits, which are expected to begin in 2023, CMS will review supporting documentation for the COVID-19 add-on payments to determine whether the documentation complied with Medicare requirements.

Source: https://oig.hhs.gov/reports-and-publications/workplan/summary/wp-summary-0000706.asp