Post PHE COVID PCR Testing

With the Public Health Emergency (PHE) ending on May 11, 2023, there are some important changes coming that impact all COVID testing requests.  Post PHE, any COVID PCR tests requested that do not meet the requirements below and/or that are not covered by a patient’s health plan will be billed to your facility.

REQUIREMENTS FOR REQUESTING

To request any COVID testing, facilities should use NICL’s NEWLY UPDATED COVID Requisition Form.  All requests for COVID testing submitted to NICL must include the following along with the completed Requisition Form:

• An ordering MD
• A corresponding order for the testing in the patient medical record
• All ICD-10 codes reflective of patient condition and symptoms present
• Any other required documentation as may be required by the payor

PAYMENT FOR COVID TESTING

While specific guidance from CMS regarding medical necessity for testing and the CDC on appropriate circumstances to test are evolving and forthcoming, we anticipate that submitting COVID PCR testing for the following reasons will NOT BE COVERED by Medicare and other health plans:

• Pre-operative or pre-procedure testing
• New admissions
• Asymptomatic exposures
• Surveillance testing

NICL Laboratories reserves the right to reject any samples or charge the facility for any testing performed where the above requirements are not satisfied or where testing is not covered by a patient’s health plan.