PMH Fees Schedule

U0003

$195

PCR Test

Infectious agent detection by nucleic acid (DNA or RNA); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, making use of high throughput technologies as described by CMS-2020-01-R.

U0005/U0004

$25

$25 add-on code for PCR tests completed within 2 days

Infectious agent detection by nucleic acid (DNA or RNA); Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), amplified probe technique, CDC or non-CDC, making use of high throughput technologies, completed within 2 calendar days from date of specimen collection (list separately in addition to either HCPCS code U0003 or U0004) as described by CMS-2020-01-R2.

86769

$125

Antibody Test

Antibody; severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]).

G2023/99211

$65

Specimen Collection

Specimen collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]), any specimen source.

36415

$25

Blood Collection

Collection of venous blood by venipuncture.

99072

$10

Additional Supplies, Materials, and Clinical Staff Time

Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service(s), when performed during a Public Health Emergency as defined by law, due to respiratory-transmitted infectious disease.

87636

$435

COVID + Influenza A & B

Infectious agent detection by nucleic acid (DNA or RNA): Severe acute respiratory syndrome Coronavirus 2 (SARS-COV-2) (CORONAVIRUS DISEASE [COVID-19] and Influenza Virus types A & B, Multiplex Amplified probe technique)